title: Accuracy of transthoracic lung ultrasound for diagnosing anesthesia-induced atelectasis in children.
abstract: BACKGROUND
  The aim of this study was to test the accuracy of lung sonography (LUS) to diagnose anesthesia-induced atelectasis in children undergoing magnetic resonance imaging (MRI).
  
  
  METHODS
  Fifteen children with American Society of Anesthesiology's physical status classification I and aged 1 to 7 yr old were studied. Sevoflurane anesthesia was performed with the patients breathing spontaneously during the study period. After taking the reference lung MRI images, LUS was carried out using a linear probe of 6 to 12 MHz. Atelectasis was documented in MRI and LUS segmenting the chest into 12 similar anatomical regions. Images were analyzed by four blinded radiologists, two for LUS and two for MRI. The level of agreement for the diagnosis of atelectasis among observers was tested using the κ reliability index.
  
  
  RESULTS
  Fourteen patients developed atelectasis mainly in the most dependent parts of the lungs. LUS showed 88% of sensitivity (95% CI, 74 to 96%), 89% of specificity (95% CI, 83 to 94%), and 88% of accuracy (95% CI, 83 to 92%) for the diagnosis of atelectasis taking MRI as reference. The agreement between the two radiologists for diagnosing atelectasis by MRI was very good (κ, 0.87; 95% CI, 0.72 to 1; P < 0.0001) as was the agreement between the two radiologists for detecting atelectasis by LUS (κ, 0.90; 95% CI, 0.75 to 1; P < 0.0001). MRI and LUS also showed good agreement when data from the four radiologists were pooled and examined together (κ, 0.75; 95% CI, 0.69 to 0.81; P < 0.0001).
  
  
  CONCLUSIONS
  LUS is an accurate, safe, and simple bedside method for diagnosing anesthesia-induced atelectasis in children.
authors.affiliation: From the Department of Anesthesia (C.M.A., G.A.M., D.J., G.T.), Department of Radiology (A.B., S.C., E.R., A.M.), and Department of Clinical Research (S.G.), Hospital Privado de Comunidad, Mar del Plata, Buenos Aires, Argentina; and Swisstom AG, Landquart, Switzerland (S.H.B.).
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Acosta
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Maidana
authors.forename: Daniel
authors.initials: D
authors.lastname: Jacovitti
authors.forename: Agustín
authors.initials: A
authors.lastname: Belaunzarán
authors.forename: Silvana
authors.initials: S
authors.lastname: Cereceda
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rae
authors.forename: Ananda
authors.initials: A
authors.lastname: Molina
authors.forename: Sergio
authors.initials: S
authors.lastname: Gonorazky
authors.forename: Stephan H
authors.initials: SH
authors.lastname: Bohm
authors.forename: Gerardo
authors.initials: G
authors.lastname: Tusman
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000592:standards; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D010865:Pilot Projects; D001261:Pulmonary Atelectasis / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results