Impact of the Ultrasonographic Assessment of Lung and Diaphragmatic Function on Postoperative Respiratory Function in Patients Undergoing Abdominal Surgery

Abstract

Abstract Background Previous studies have evaluated the feasibility of diaphragmatic ultrasonography or lung ultrasound in the PACU, but the clinical significance of combined evaluation of the two in improving postoperative respiratory function in patients under general anesthesia has not been confirmed.We hypothesized that ultrasound evaluation of lung and diaphragm function would lead to more effective intervention measures to improve the recovery of respiratory function in patients undergoing general anesthesia recovery after abdominal surgery. Methods This study included a total of 130 patients who underwent elective abdominal surgery in our hospital and were planned to be sent to the Post-Anesthesia Care Unit (PACU). The patients were randomly divided into an ultrasound group (group DL) and the control group (group N). In the group DL , LUS and diaphragm ultrasonography were performed at room entry (T0), entry into the PACU (T1), 15 minutes after extubation (T2), and exit from the PACU (T3). Lung ultrasound score (LUSS) and the diaphragm thickening fraction (DTF) at each time point were recorded and intervention based on the ultrasound results were performed in the group DL, Conventional resuscitation without ultrasound assessment was used in group N. Arterial blood gas analysis and oxygenation index were recorded at T3 of patients in both groups.The all patients were followed up for seven days after operation for pulmonary complications. Results Compared with T0, DTF decreased significantly (P<0.01) and LUSS increased significantly (P<0.01) after T1, T2, and T3 in the DL group, and did not return to the preoperative level at T3 (P<0.01). Compared with the group N, the total number of intervention measures in the group DL and the number of taking intervention measures in the group DL at T1 increased (P<0.05). Compared with the group N, the extubation time, PACU length-of-stay, and incidence of postoperative hypoxemia at T3 in the group DL were significantly reduced (P<0.01). Conclusion Ultrasound evaluation of lung and diaphragm function can dynamically monitor the ventilation status and diaphragm function recovery degree of patients during anesthesia recovery, so as to take effective intervention measures to improve the recovery of respiratory function in patients undergoing general anesthesia after abdominal surgery.