Lung Ultrasonography and Pediatric Cardiac Surgery: First Experience With a New Tool for Postoperative Lung Complications Vincenzo Vitale, MD, Zaccaria.

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Lung Ultrasonography and Pediatric Cardiac Surgery: First Experience With a New Tool for Postoperative Lung Complications Vincenzo Vitale, MD, Zaccaria Ricci, MD, Paola Cogo, MD, PhD The Annals of Thoracic Surgery Volume 97, Issue 4, Pages e121-e124 (April 2014) DOI: 10.1016/j.athoracsur.2014.01.060 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Case 1: (a) pleural effusion as seen on chest radiograph; (b) the quad sign; (c) the sinusoid sign by M-mode; and (d) chest radiograph after pleural drainage. Case 2: (a) pneumothorax as seen on chest radiograph; (b) in M-mode, arrows show the stratosphere sign (collapsed lung); (c) the lung point that highlights the passage from normal lung (seashore sign) to collapsed lung (stratosphere sign); and (d) chest radiograph after pleural drainage. Case 3: (a) the lung consolidation clearly shown by the radiograph; (b) the shredded pattern by lung ultrasonography; and (c) chest radiograph that shows lung after antibiotic therapy. The Annals of Thoracic Surgery 2014 97, e121-e124DOI: (10.1016/j.athoracsur.2014.01.060) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Case 4 before operation: (a) right apex atelectasis on chest radiograph; (b) the heart pulsatility on lung parenchyma by ultrasound color Doppler; and (c) computed tomography image that confirmed right lung atelectasis. Case 4 after operation: (a) chest radiograph without right lung apex atelectasis; (b) the absence of heart pulsatility on lung parenchyma by ultrasound color Doppler; and (c) computed tomography image with right lung reexpansion after Norwood operation. Case 5: (a) chest radiograph image compatible with right pleural effusion and lung consolidation (atelectasis); (b) ultrasonography image that shows right costodiaphragmatic sinus with pleural effusion before therapy; (c) chest radiograph after diuretics and noninvasive ventilation. Case 5: (d, e, f) right lung reaeration; arrows show normal lung A lines replacing atelectasis during noninvasive ventilation in three progressive moments. The Annals of Thoracic Surgery 2014 97, e121-e124DOI: (10.1016/j.athoracsur.2014.01.060) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions