Lung Ultrasound Score After ENT Cancer Surgery

Study Overview
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Brief Summary
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After ENT cancer surgery, postoperative respiratory complications are common, especially after tracheostomy. The objective of this study is to characterize the pulmonary status of patients after ENT cancer surgery. We wish to collect and analyze the pulmonary abnormalities revealed by the ultrasound scans performed in the post-anesthesia care unit (PACU), at day 1 and at day 2 after ENT cancer surgery with tracheostomy.

Detailed Description
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After ENT cancer surgery, postoperative respiratory complications are common, especially after tracheostomy. Problems with lung ventilation called atelectasis are largely associated with these complications. These atelectasis develop within minutes of the start of general anesthesia. Patients who develop a complication require longer postoperative oxygen treatment and more physical therapy. The diagnosis of atelectasis can be made by standard chest radiography, which is a source of radiation and requires moving the patient. An alternative technique, lung ultrasound, is a non-irradiating examination that can be performed in the patient's bed. It is routinely performed in the postoperative surveillance room and in the intermediate care unit at the Centre Léon Bérard. The objective of this study is to characterize the pulmonary status of patients after ENT cancer surgery. We wish to collect and analyze the pulmonary abnormalities revealed by the ultrasound scans performed in the post-anesthesia care unit (PACU), at day 1 and at day 2 after ENT cancer surgery with tracheostomy.

Official Title
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Lung Ultrasound Score After Ear, Nose and Throat Cancer Surgery

Conditions
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Cancer of Head and Neck, Tracheostomy, Postoperative Pulmonary Complication, Surgery

Intervention / Treatment
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* Diagnostic Test: Lung ultrasound score


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ENT cancer surgery with tracheostomy or tracheotomy Exclusion Criteria: under 18 years old deprivation of liberty pre-existing tracheotomy or tracheostomy patient refusal

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ENT cancer surgery patients<br>all patients undergoing ENT cancer surgery with tracheotomy or tracheostomy at the Centre Léon Bérard. | Diagnostic Test: Lung ultrasound score<br>* To evaluate the incidence of pulmonary atelectasis in the post-anesthesia care unit (PACU) using lung ultrasound.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung ultrasound score, in the PACU after ENT cancer surgery. | Lung ultrasound score : Images were obtained in PACU. Care was taken to set the focal zone on the pleural line. The thorax was divided into 12 quadrants: anterior, lateral, and posterior zones (separated by the anterior and posterior axillary lines) each divided in upper and lower portions for the right and left lung. Intercostal spaces of each of these areas were scanned and a cine-loop of the most pathologic area of each quadrant was saved to digital format. A semiquantitative score, the lung ultrasound (LUS) score, was calculated to assess lung aeration at each time point as described by Monastesse. | Up to 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung ultrasound score, on day 2 after ENT cancer surgery. | Lung ultrasound score : Images were obtained on day 2 after PACU (in intermediate care unit). Care was taken to set the focal zone on the pleural line. The thorax was divided into 12 quadrants: anterior, lateral, and posterior zones (separated by the anterior and posterior axillary lines) each divided in upper and lower portions for the right and left lung. Intercostal spaces of each of these areas were scanned and a cine-loop of the most pathologic area of each quadrant was saved to digital format. A semiquantitative score, the lung ultrasound (LUS) score, was calculated to assess lung aeration at each time point as described by Monastesse. | on the 2nd day after surgery | 
| Lung ultrasound score, on day 1 after ENT cancer surgery. | Lung ultrasound score : Images were obtained on day 1 after PACU (in intermediate care unit). Care was taken to set the focal zone on the pleural line. The thorax was divided into 12 quadrants: anterior, lateral, and posterior zones (separated by the anterior and posterior axillary lines) each divided in upper and lower portions for the right and left lung. Intercostal spaces of each of these areas were scanned and a cine-loop of the most pathologic area of each quadrant was saved to digital format. A semiquantitative score, the lung ultrasound (LUS) score, was calculated to assess lung aeration at each time point as described by Monastesse. | on the 1st day after surgery | 
| To assess the incidence of pulmonary atelectasis in the PACU by chest radiography. | pulmonary atelectasis on chest radiography | Up to 24 hours | 
| Study gas exchange in PACU | SpO2/FiO2 | up to 24 hours | 
| Study gas exchange on day 1 after surgery | SpO2/FiO2 | on the 1st day after surgery | 
| Study gas exchange on day 2 after surgery | SpO2/FiO2 | on the 2nd day after surgery | 
| incidence of postoperative respiratory complications in the month following ENT cancer surgery (eg number of participants with a postoperative respiratory complication) | number of participants who had a postoperative respiratory complication within 30 days of surgery: atelectasis, pulmonary oedema, consolidation, pneumothorax, pleural effusion, bronchospasm, pneumonia. | up to 31 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative pulmonary complication, Lung ultrasound, Tracheostomy, ENT cancer surgery