Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;35(6):1213-1218.
doi: 10.1080/14767058.2020.1743660. Epub 2020 Mar 26.

LUCAS (lung ultrasonography in cardiac surgery) score to monitor pulmonary edema after congenital cardiac surgery in children

M Girona-Alarcón  1 , A Cuaresma-González  2 , J Rodríguez-Fanjul  3 , S Bobillo-Perez  1   4 , E Inarejos  5 , J Sánchez-de-Toledo  6 , I Jordan  7 , M Balaguer  1
Affiliations

LUCAS (lung ultrasonography in cardiac surgery) score to monitor pulmonary edema after congenital cardiac surgery in children

M Girona-Alarcón et al. J Matern Fetal Neonatal Med. 2022 Mar.

Abstract

Aim: Cardiopulmonary bypass (CPB) generates a systemic capillary leak syndrome with pulmonary edema. Lung ultrasound (LUS) could be useful to monitor it. Primary objective was to compare sensitivity, specificity, positive and negative predictive values of chest X-ray and LUS to detect pulmonary edema using a new score (LUCAS). Secondary objectives were to evaluate correlation between LUCAS score and respiratory and inotropic support.

Methods: Prospective intervention study including patients <2 months admitted to the Pediatric Intensive Care Unit after CPB. LUS was performed with a lineal probe, screening 3 points in each lung (parasternal, anterolateral and posterior area), pre and post-CPB. Pulmonary edema was evaluated clinically, through LUCAS score and with X-ray.

Results: 17 patients were included. LUS achieved higher sensitivity than X-ray to detect pulmonary edema (91.7 versus 44.0%) and greater predictive negative value (88.2 versus 53.3%). There was correlation between higher LUCAS score prior to surgery and longer mechanical ventilation. High values of LUCAS score after surgery correlated with longer CPB time, inotropic support, and FiO2 need.

Conclusion: LUS detected pulmonary edema better than chest X-ray, with greater sensitivity and negative predictive value. LUCAS score was useful to predict more inotropic support and longer mechanical ventilation.Key notesCardiopulmonary bypass during cardiac surgery, generates a systemic capillary leak syndrome with pulmonary edema.In this prospective study performed in the Pediatric Intensive Care Unit, lung ultrasound detected pulmonary edema better than X-ray, with greater sensitivity and negative predictive value.LUCAS score was useful to predict more inotropic support and longer mechanical ventilation.

Keywords: Cardiac surgery; cardiopulmonary bypass; lung ultrasound; pediatric intensive care; pediatrics; pulmonary edema; score.

PubMed Disclaimer

LinkOut - more resources