Integrated use of bedside lung ultrasound and echocardiography to manage pediatric patients with respiratory failure and shock in pediatric intensive care unit
10.3760/cma.j.issn.1673-4912.2015.08.006
- VernacularTitle:床旁心肺整合超声指导心肺衰竭患儿诊治
- Author:
Jian ZHANG
;
Li ZHAO
;
Kang AN
;
Sijuan SUN
;
Hong REN
;
Xiaowei HU
;
Juan QIAN
;
Biru LI
;
Ying WANG
- Publication Type:Journal Article
- Keywords:
Lung ultrasound;
Respiratory failure;
Shock;
Critical care;
Children
- From:
Chinese Pediatric Emergency Medicine
2015;22(8):543-547
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of integrated use of bedside lung ultrasound and echo-cardiography in PICU.Methods Two cases with respiratory failure and shock were monitored using inte-grated bedside lung ultrasound and echocardiography.Breathing and circulation support solutions were adopt-ed according to Bedside Lung Ultrasound in Emergency(BLUE)and Fluid Administration Limited by Lung Sonography(FALLS).Results Case 1 with acute lymphoblastic leukemia complicated with severe phneu-monia was measured as “B-profile”throughout both lung fields which interpreted as pulmonary edema ac-cording to the BLUE protocol.He was diagnosed as acute respiratory distress syndrome later and supported by non-invasive ventilation according to the lung ultrasonography.After 4 days,the numbers of B line were sig-nificantly reduced with PaO2/FiO2 >300 mmHg(1 mmHg=0.133 kPa)and the improvement in chest X ra-diography was found,ventilation was weaned accordingly.Case 2 was diagnosed as septic shock and acute re-spiratory distress syndrome with volume resuscitation and mechanical ventilation.According to FALLS proto-col,we ruled out obstructive and cardiogenic shock,and assessed the variation in inferior vena cava diameter and aortic systolic velocity-time integral as a guide to fluid therapy.At the 8th hour in PICU,case 2 recovered from shock.Conclusion Integrated use of bedside lung ultrasound and echocardiography is clinically signifi-cant for the rescue of critically ill patient with respiratory failure and shock.
