Subpulmonary pleural effusions in children after cardiac surgery

Area of Science:

• Pediatric Cardiology
• Thoracic Surgery
• Diagnostic Imaging

Background:

• Postoperative complications after pediatric cardiac surgery require careful monitoring.
• Subpulmonary effusions are a potential, though not well-documented, complication following these procedures.

Purpose of the Study:

• To determine the frequency of subpulmonary effusions in children after cardiac operations.
• To describe radiographic findings suggestive of subpulmonary effusions.
• To assess the management and outcome of detected subpulmonary effusions.

Main Methods:

• Retrospective review of 100 postoperative chest radiographs in children undergoing cardiac surgery.
• Confirmation of effusions using lateral decubitus radiographs.
• Echocardiography to rule out pericardial effusions.
• Clinical follow-up to assess fluid resolution.

Main Results:

• Subpulmonary effusions were confirmed in 11% (9 of 83) of patients with adequate radiographs.
• Radiographic signs included increased distance between diaphragm and gastric fundus or elevated right hemidiaphragm.
• No associated pericardial effusions were detected by echocardiography.
• Diuretic therapy was initiated or continued for detected effusions.

Conclusions:

• Subpulmonary effusions are an infrequent finding after pediatric cardiac surgery.
• Specific radiographic findings can aid in their diagnosis.
• Diuretic treatment appears effective in resolving these effusions, with no residual fluid at two-week follow-up.