Lung Ultrasonography After Major Cardiac Surgery

NCT03279887 | Completed

• 1 other identifier: ECHOVAP
• Study Type: observational
• Target: 51
• Locations: 0 countries
• Sites: N/A

Brief Summary

Diagnosis of pneumonia remains difficult in intensive care unit (ICU), notably after cardiac surgery. Lung ultrasonography (LUS) has been successfully used for diagnosis of pneumonia, but its usefulness and reliability was never evaluated after cardiac surgery. This study investigates the clinical relevance of LUS for pneumonia diagnoses in cardiac ICU.

Conditions

Pneumonia; Cardio/Pulm: Respiratory Failure; Cardiopulmonary Bypass

Outcome Measures

Primary Outcomes (1)

• Final diagnosis of pneumonia

  Pneumonia or excluded pneumonia, was determined by consensus of 3 investigators, after an independent post hoc review of the medical records. Pneumonia diagnosis was based on concordance of clinical and radiological criteria (≥ 2 criteria including fever\> 38.5 ° C or T \<36 ° C, leukocytosis\> 10 \^ 9 / L or leukopenia \<4.10 \^ 8 / L, purulent tracheal secretions and the appearance or persistence of an infiltrate on the CXR). It should be confirmed by culture of a respiratory specimen: protected distal sampling with a threshold of significance ≥ 10 \^ 3 colony forming unit/mL or bronchoalveolar lavage with a threshold of significance ≥ 10 \^ 4 CFU/mL.

  During the 72 hours following surgery

Study Arms (1)

Post operative respiratory failure

Patients with acute respiratory failure (ARF) less than 72 hours after a major cardiac surgery with cardiopulmonary bypass ARF was defined as one of the following conditions: * If mechanical ventilation, a partial pressure of oxygen/ inspired oxygen fraction ratio (PaO2/FiO2) \< 200, or failure of weaning (failure of spontaneous ventilation test, re-intubation in the first 24 hours), or need for non-invasive ventilation immediately after extubation, * If spontaneous ventilation: clinical signs of acute respiratory distress (dyspnea at least exertion, cyanosis, polypnea\> 25/min, upper or intercostal swallowing, abdominal swing ...), pulse oximetry (SpO2) \< 90% or PaO2 \<60 mmHg despite oxygen therapy ≥ 3 L/min.

Diagnostic Test: Lung Ultrasound

Interventions

Lung Ultrasound DIAGNOSTIC_TEST

Post operative respiratory failure

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with acute respiratory failure after cardiac surgery and hospitalized in the surgical Intensive Care Unit of ICU of Cardiology Institute, Pitié Salpêtrière University Hospital, Paris, France

You may qualify if:

• Cardiac surgery with sternotomy and cardio-pulmonary bypass (CPB) less than 3 days before
• At least one component suggestive of ARF:
• If mechanical ventilation, a PaO2 / FiO2 ratio \<200, or failure of weaning (failure of spontaneous ventilation test, re-intubation in the first 24 hours), or need for non-invasive ventilation immediately after extubation,
• If spontaneous ventilation: clinical signs of acute respiratory distress (dyspnea at least exertion, cyanosis, polypnea\> 25/min, upper or intercostal swallowing, abdominal swing ...), SpO2 \< 90% or PaO2 \<60 mmHg despite oxygen therapy ≥ 3L/min.

You may not qualify if:

• Minor patients
• Pregnancy
• Sleep apnea syndrome
• Participation refusal

Sponsors & Collaborators

• Groupe Hospitalier Pitie-Salpetriere: lead

Related Publications (1)

• Dureau P, Bougle A, Melac AT, Ait Hamou N, Arbelot C, Ben Hassen K, Charfeddine A, Deransy R, Arcile G, Rouby JJ, Granger B, Amour J. Colour Doppler ultrasound after major cardiac surgery improves diagnostic accuracy of the pulmonary infection score in acute respiratory failure: A prospective observational study. Eur J Anaesthesiol. 2019 Sep;36(9):676-682. doi: 10.1097/EJA.0000000000001022.

  PMID: 31107351 DERIVED

MeSH Terms

Conditions

Pneumonia

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 4, 2017
• First Posted: September 12, 2017
• Study Start: January 1, 2015
• Primary Completion: May 1, 2015
• Study Completion: September 1, 2016
• Last Updated: September 13, 2023

Record last verified: 2023-09

Data Sharing

• IPD Sharing: Will not share