Lung Recruitment Maneuvers Assessment by Bedside Lung Ultrasound in Pediatric Acute Respiratory Distress Syndrome
Por:
Mor Conejo M, Guitart-Pardellans C, Fresán-Ruiz E, Penela Sánchez D, Cambra-Lasaosa FJ, Jordán-García I, Balaguer-Gargallo M and Pons-Odena M
Publicada:
1 jun 2022
Ahead of Print:
27 may 2022
Categoría:
Pediatrics, perinatology and child health
Resumen:
The use of recruitment maneuvers (RMs) is suggested to improve severe oxygenation failure in patients with acute respiratory distress syndrome (ARDS). Lung ultrasound (LUS) is a non-invasive, safe, and easily repeatable tool. It could be used to monitor the lung recruitment process in real-time. This paper aims to evaluate bedside LUS for assessing PEEP-induced pulmonary reaeration during RMs in pediatric patients. A case of a child with severe ARDS due to Haemophilus influenzae infection is presented. Due to his poor clinical, laboratory, and radiological evolution, he was placed on venovenous extracorporeal membrane oxygenation (ECMO). Despite all measures, severe pulmonary collapse prevented proper improvement. Thus, RMs were indicated, and bedside LUS was successfully used for monitoring and assessing lung recruitment. The initial lung evaluation before the maneuver showed a tissue pattern characterized by a severe loss of lung aeration with dynamic air bronchograms and multiple coalescent B-lines. While raising a PEEP of 30 mmH(2)O, LUS showed the presence of A-lines, which was considered a predictor of reaeration in response to the recruitment maneuver. The LUS pattern could be used to assess modifications in the lung aeration, evaluate the effectiveness of RMs, and prevent lung overdistension.
Filiaciones:
Mor Conejo M:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Guitart-Pardellans C:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Fresán-Ruiz E:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Cambra-Lasaosa FJ:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Jordán-García I:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, CIBERESP, Esplugues de Llobregat, 08950 Barcelona, Spain
Balaguer-Gargallo M:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Pons-Odena M:
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Deu, University of Barcelona, 08950 Barcelona, Spain.; Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain.; Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Deu, CIBERESP, Esplugues de Llobregat, 08950 Barcelona, Spain.
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