Diagnosis Of Pulmonary Complications After Cardiac Surgery In Children
Condition: Children; Cardiac Surgery; Ultrasound
Study type: Observational

Summary: 
      Pulmonary complications are frequent in cardiac surgery, representing an important cause of
      morbidity, prolongation of hospital stay and need for repeated examinations.Chest X-rays are
      done routinely and even multiple times to detect such complications.Lung ultrasonography is
      an alternative test to detect pulmonary complications that can be done easily on bedside.
      Regularly done Chest X-ray exposes patient to ionizing radiation which can be reduced with
      ultrasonography. Lung ultrasound is gaining popularity in recent years as a
      non-invasive,radiation-free tool for the diagnosis of various acute and chronic pulmonary
      diseases due to its bedside convenience, accuracy, and free of radiation.There is increasing
      evidence to support the use of Lung ultrasound in acute care setting and post-cardiac
      surgical patients are also considered critically ill. The purpose of this study is to compare
      diagnostic performance of lung ultrasound in comparison to chest X-ray to detect pulmonary
      complication after cardiac surgery in children.
    

Detailed description: 
      Study type: Comparative Study design: Non-randomized,all patients will undergo both
      ultrasound and chest Xray.

      Model:cohort time perspective: prospective Sampling method: non-probability sample Study
      population: Children less than 14 years Sample size: 54 Place of Study-Shahid Gangalal
      national Heart Center, Surgical intensive care unit Duration of study: six months Hypothesis:
      Chest X-ray and Lung ultrasound are equally effective in detecting postoperative pulmonary
      complications

      Inclusion criteria:

      Patients after undergoing cardiac surgery who are age below 14 years on post-operative Day 1.

      Exclusion criteria Patient's /Guardians' refusal IMAGING PROTOCOL AND TECHNIQUE Following
      institutional review board approval, a written informed consent will be obtained from all the
      patients meeting the inclusion criteria before undergoing surgery on pre-operative visit
      before enrollment in the study.

      Lung Ultrasound will be done on the first post-operative day of cardiac surgery and will be
      compared to Chest X-ray done on the same day for any pulmonary complications . Lung
      ultrasound examination will be performed by radiologist to detect pleural effusion,
      consolidation, pulmonary atelectasis, pneumothorax and pulmonary congestion, using Siemens
      AUCUSON Freestyle Diagnostic Ultrasound System L13-5 linear probe. The transthoracic Lung
      ultrasound approach will be done in supine and both lateral decubitus positions of the
      anterior lung area (between the sternum and the anterior axillary line), lateral lung area
      (between the anterior and posterior axillary lines), and posterior lung area (between the
      posterior axillary line and the spine) in caudo-cranial direction. Longitudinal, transverse
      and oblique scans will be included. A routine plain chest radiograph will be obtained in each
      patient on the same day before performing ultrasound which will be evaluated by an
      intensivist to detect pleural effusion, consolidation, pulmonary atelectasis, pneumothorax.
      Both the radiologist and intensivist will be blinded to each other's findings. Comparison of
      the findings will be done at the end of study.
    

Intervention name(s): Chest Radiograph; Lung Ultrasound
Intervention type(s): Radiation; Diagnostic Test
Intervention description(s): Chest radiogram will be obtained on day 1; Lung ultrasound will be done on day 1
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Pediatric patients aged less than 14 years scheduled for cardiac surgery