Point-of-Care Lung Ultrasound to Evaluate Lung Isolation During One-Lung Ventilation in Children: Narrative Review

Area of Science:

• Pediatric Anesthesiology
• Medical Imaging
• Thoracic Surgery

Background:

• Lung isolation is critical during thoracic surgery to ensure patient safety and optimize surgical conditions.
• Traditional methods for confirming lung isolation, such as auscultation, have limitations in accuracy, especially in pediatric patients.
• Point-of-care ultrasound (POCUS) has emerged as a promising non-invasive bedside tool for various clinical assessments.

Purpose of the Study:

• To review the current techniques and evidence for utilizing POCUS in evaluating lung isolation in infants and children undergoing thoracic surgery.
• To demonstrate the POCUS technique in pediatric patients and highlight differences compared to adult patients.
• To assess the accuracy and utility of POCUS as an alternative to auscultation for confirming lung ventilation.

Main Methods:

• Review of existing literature and previous reports on POCUS for lung isolation in pediatric populations.
• Demonstration of POCUS techniques using figures and high-quality video examples.
• Description of key ultrasound findings indicative of lung ventilation, including lung sliding (B-mode) and the seashore sign (M-mode).

Main Results:

• POCUS provides visual confirmation of lung ventilation, with specific signs like lung sliding and the seashore sign indicating successful isolation.
• The review presents relevant findings from previous reports in infants and children.
• The technique is demonstrated to be feasible and applicable to pediatric patients, with noted differences from adult assessments.

Conclusions:

• Point-of-care ultrasound is a non-invasive and potentially more accurate method for confirming lung isolation in pediatric thoracic surgery compared to auscultation.
• Pediatric anesthesiologists should become proficient in POCUS for lung isolation assessment.
• Familiarity with POCUS can enhance patient safety and procedural efficiency in pediatric thoracic surgery.