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Bedside Ultrasound for the Diagnosis of Abnormal Diaphragmatic Motion in Children After Heart Surgery.
Pediatr Crit Care Med ; 18(2): 159-164, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27801709
ABSTRACT

OBJECTIVE:

To assess the utility of bedside ultrasound combining B- and M-mode in the diagnosis of abnormal diaphragmatic motion in children after heart surgery.

DESIGN:

Prospective post hoc blinded comparison of ultrasound performed by two different intensivists and fluoroscopy results with electromyography.SETTING: Tertiary university hospital.

SUBJECTS:

Children with suspected abnormal diaphragmatic motion after heart surgery.INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS:

Abnormal diaphragmatic motion was suspected in 26 children. Electromyography confirmed the diagnosis in 20 of 24 children (83.3%). The overall occurrence rate of abnormal diaphragmatic motion during the study period was 7.5%. Median patient age was 5 months (range, 16 d to 14 yr). Sensitivity and specificity of chest ultrasound performed at the bedside by the two intensivists (91% and 92% and 92% and 95%, respectively) were higher than those obtained by fluoroscopy (87% and 83%). Interobserver agreement (k) between both intensivists was 0.957 (95% CI, 0.87-100).

CONCLUSIONS:

Chest ultrasound performed by intensivists is a valid tool for the diagnosis of diaphragmatic paralysis, presenting greater sensitivity and specificity than fluoroscopy. Chest ultrasound should be routinely used after pediatric heart surgery given its reliability, reproducibility, availability, and safety.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Paralisia Respiratória / Diafragma / Testes Imediatos / Procedimentos Cirúrgicos Cardíacos Aspecto clínico: Diagnóstico / Predição Limite: Adolescente / Criança / Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino / Recém-Nascido Idioma: Inglês Revista: Pediatr Crit Care Med Assunto da revista: Pediatria / Terapia Intensiva Ano de publicação: 2017 Tipo de documento: Artigo