Related Experiment Video
Updated: Dec 7, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Lung ultrasound compared with bedside chest radiography in a paediatric cardiac intensive care unit
Tammam Hasan1, Simone Bonetti1, Anna Gioachin2
1Paediatric Cardiology and ACHD Unit, S. Orsola - Malpighi Hospital, Bologna, Italy.
Insights
Lung ultrasound (LUS) effectively identifies postoperative pulmonary complications like pneumothorax (PNX), pleural effusion (PLE), and pulmonary consolidation (PC) in children after heart surgery. This bedside tool shows good agreement with chest X-ray (CXR), offering a valuable alternative.
Area of Science:
- Pediatric Cardiology
- Pulmonology
- Medical Imaging
Background:
- Postoperative pulmonary complications (pneumothorax, pleural effusion, pulmonary consolidation) impede recovery in pediatric cardiac surgery patients.
- Lung ultrasound (LUS) is an emerging diagnostic tool for pediatric pulmonary diseases.
- LUS demonstrates accuracy in diagnosing pleural and parenchymal lung conditions.
Purpose of the Study:
- To evaluate the diagnostic accuracy of LUS for pneumothorax (PNX), pleural effusion (PLE), and pulmonary consolidation (PC) in pediatric patients following heart surgery.
- To compare the efficacy of LUS against chest X-ray (CXR) in identifying these specific pulmonary complications.
Main Methods:
- A comparative study involving 53 pediatric patients (0-17 years) undergoing cardiac surgery.
- Simultaneous evaluation of patients using both LUS and CXR in the postoperative period.
- Assessment focused on the recognition of PNX, PLE, and PC by both imaging modalities.
Main Results:
- LUS exhibited good agreement for PNX and moderate agreement for PLE and PC when compared to CXR.
- LUS demonstrated significantly superior relative sensitivity compared to CXR for detecting PC and PLE.
- Conversely, CXR showed significantly superior relative sensitivity for PNX detection.
Conclusions:
- LUS shows sufficient diagnostic agreement with CXR for evaluating postoperative pulmonary complications in pediatric cardiac surgery.
- The non-inferior diagnostic performance and ease of bedside application make LUS a highly valuable tool for pediatric cardiac intensive care units.
Aim:
Postoperative recovery of children with heart disease is encumbered by pulmonary complications like pneumothorax (PNX), pleural effusion (PLE), interstitial oedema and pulmonary consolidation (PC). Recently, lung ultrasound (LUS) has become an important diagnostic tool for evaluation of pulmonary diseases in the paediatric context. LUS is accurate in diagnosing pleural and parenchymal diseases. The aim of this study was to evaluate the accuracy of LUS in the identification of PNX, PLE and PC in a paediatric population of patients with congenital heart disease after heart surgery.
Methods:
Fifty-three patients aged 0-17 years who underwent cardiac surgery were evaluated in the postoperative period by chest X-ray (CXR) and LUS at the same time. The methods where compared for recognition of PNX, PLE and PC.
Results:
LUS showed a good agreement for PNX and a moderate agreement for both PLE and PC. LUS also showed a significantly superior relative sensitivity than CXR for PC and PLE and a significantly inferior relative sensitivity for PNX.
Conclusion:
This study confirms that LUS has a sufficient agreement rate with the current clinical standard (CXR). Non-inferiority in diagnosis together with the easiness of bedside performance makes LUS a very attractive tool for the paediatric cardiac intensive care unit.
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