title: Performance of Lung Ultrasound in Detecting Peri-Operative Atelectasis after General Anesthesia.
abstract: The aim of this prospective observational study was to evaluate the performance of lung ultrasound (LUS) in detecting post-operative atelectasis in adult patients under general anesthesia. Forty-six patients without pulmonary comorbidities who were scheduled for elective neurosurgery were enrolled in the study. A total of 552 pairs of LUS clips and thoracic computed tomography (CT) images were ultimately analyzed to determine the presence of atelectasis in 12 prescribed lung regions. The accuracy of LUS in detecting peri-operative atelectasis was evaluated with thoracic CT as gold standard. Levels of agreement between the two observers for LUS and the two observers for thoracic CT were analyzed using the κ reliability test. The quantitative correlation between LUS scores of aeration and the volumetric data of atelectasis in thoracic CT were further evaluated. LUS had reliable performance in post-operative atelectasis, with a sensitivity of 87.7%, specificity of 92.1% and diagnostic accuracy of 90.8%. The levels of agreement between the two observers for LUS and for thoracic CT were both satisfactory, with κ coefficients of 0.87 (p < 0.0001) and 0.93 (p < 0.0001), respectively. In patients in the supine position, LUS scores were highly correlated with the atelectasis volume of CT (r = 0.58, p < 0.0001). Thus, LUS provides a fast, reliable and radiation-free method to identify peri-operative atelectasis in adults.
authors.affiliation: Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Zhenping
authors.initials: Z
authors.lastname: Zhai
authors.affiliation: Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Yongfeng
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Jianbin
authors.initials: J
authors.lastname: Tong
authors.affiliation: Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Jianqin
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China. Electronic address: ouyangwen133@vip.sina.com.
authors.forename: Wen
authors.initials: W
authors.lastname: Ouyang
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
keywords: Atelectasis; General anesthesia; Lung ultrasound; Thoracic computed tomography