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Research paper
Published online: 2021-02-23
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Perioperative lung ultrasound pattern changes in patients undergoing gynecological procedures — a prospective observational study

Pawel Krawczyk, Agnieszka Jastrzebska, Wojciech Szczeklik, Janusz Andres
DOI: 10.5603/GP.a2021.0017

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-02-23

Abstract

Objectives: General anesthesia and positive pressure ventilation are associated with perioperative pulmonary complications.
Lung ultrasound (LUS) is a method used to evaluate lung parenchyma. The purpose of this study was to evaluate LUS
patterns in a cohort of women undergoing gynecological surgery with uncomplicated general anesthesia.
Material and methods: Patients were assessed according to the 8-zone LUS assessment protocol used to detect lung
sliding, A-lines, B-lines, interstitial syndrome and lung consolidation. Each patient was screened at specific time intervals:
before induction of anesthesia, at induction, 30 and 60 minutes after induction and within two hours after recovery.
Results: A total of 99 patients undergoing gynecological surgery with uneventful anesthesia from November 2017 to November
2018 were included in this study. A total of 426 LUS records were retained for further analysis. Overall, no significant
changes to patients’ A-line appearance were detected, regardless of the time of assessment. There was, however, an increase
in the number of B-lines at the screening times of 30 and 60 minutes after induction, as compared to initial assessments
(p = 0.011 and p < 0.001 respectively), and an increase in the number of positive regions (≥ 3 B-lines) at 30 and 60 minutes
after induction and after recovery, as compared to initial assessment (p < 0.001; p < 0.001 and p = 0.001 respectively).
Conclusions: An uneventful anesthesia may predispose to abnormal LUS findings and should be considered while interpreting
of LUS results in cases with perioperative pulmonary complications.

Abstract

Objectives: General anesthesia and positive pressure ventilation are associated with perioperative pulmonary complications.
Lung ultrasound (LUS) is a method used to evaluate lung parenchyma. The purpose of this study was to evaluate LUS
patterns in a cohort of women undergoing gynecological surgery with uncomplicated general anesthesia.
Material and methods: Patients were assessed according to the 8-zone LUS assessment protocol used to detect lung
sliding, A-lines, B-lines, interstitial syndrome and lung consolidation. Each patient was screened at specific time intervals:
before induction of anesthesia, at induction, 30 and 60 minutes after induction and within two hours after recovery.
Results: A total of 99 patients undergoing gynecological surgery with uneventful anesthesia from November 2017 to November
2018 were included in this study. A total of 426 LUS records were retained for further analysis. Overall, no significant
changes to patients’ A-line appearance were detected, regardless of the time of assessment. There was, however, an increase
in the number of B-lines at the screening times of 30 and 60 minutes after induction, as compared to initial assessments
(p = 0.011 and p < 0.001 respectively), and an increase in the number of positive regions (≥ 3 B-lines) at 30 and 60 minutes
after induction and after recovery, as compared to initial assessment (p < 0.001; p < 0.001 and p = 0.001 respectively).
Conclusions: An uneventful anesthesia may predispose to abnormal LUS findings and should be considered while interpreting
of LUS results in cases with perioperative pulmonary complications.

Get Citation

Keywords

lung ultrasound; perioperative care; B-lines; interstitial syndrome

About this article
Title

Perioperative lung ultrasound pattern changes in patients undergoing gynecological procedures — a prospective observational study

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-02-23

DOI

10.5603/GP.a2021.0017

Keywords

lung ultrasound
perioperative care
B-lines
interstitial syndrome

Authors

Pawel Krawczyk
Agnieszka Jastrzebska
Wojciech Szczeklik
Janusz Andres

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