[Pulmonary ultrasound guidance of congenital heart disease postoperative ventilator applications].

OBJECTIVE: To investigate the pulmonary ultrasound in children with congenital heart disease postoperative invasive ventilator time, non-invasive ventilator use the guide.

METHODS: Using prospective clinical observation research methods, Randomly divide 100 cases ranged from 6 months to 3 years old in cardiopulmonary bypass after congenital heart disease surgery patients into ultrasound group and control group, 50 cases in each group. All postoperative give positive cardiac function maintenance, diuresis, etc. Ultrasound group adopted the pulmonary ultrasound in children with pulmonary interstitial pulmonary edema monitoring and guide to extubation, enable the timing of the noninvasive ventilator support; Control group based on the bedside chest X-ray lung condition. Compare two groups of children with mechanical ventilation time (including the invasive and noninvasive ventilator support), noninvasive ventilator utilization rate and its accuracy, start the noninvasive ventilator time, the incidence of ventilator associated pneumonia (VAP), secondary tracheal intubation cases and ICU stay time, etc.

RESULTS: The ultrasound group compared with the control group in Invasive ventilator time [(15.0 ± 11.0) vs (20.0 ± 13.5, P=0.043)], noninvasive ventilation time [(38.5 ± 11.8) vs (48.6 ± 21.9, P=0.032)], the number of cases of the use of noninvasive ventilation (10 cases vs 22 cases, P=0.041), the correct use of the number of cases (10 vs 14, P=0.034) and VAP cases (3 vs 8, P=0.044), there was statistical significance, P< 0.05. The ultrasound group of children with ICU stay time was significantly lower than the control group [(66.0 ± 38.9) vs (82.0 ± 42.4, P=0.038)]; Control group had 2 cases with secondary tracheal intubation, ultrasound group one, comparing the two groups has no statistical significance (P> 0.05).

CONCLUSION: Postoperative children with congenital heart disease using pulmonary ultrasound evaluation of pulmonary interstitial edema,guide the ventilator, it can effectively shorten (invasive and noninvasive mechanical ventilation time and ICU length of hospital stay, lung ultrasound has instant, noninvasive, No radiation, repeatable,pulmonary ultrasound will be important after cardiopulmonary bypass interstitial lung edema diagnosis, evaluation of treatment means and helps to treat critically ill children.