Application of Lung Ultrasound in Monitoring Fluid Overload During Transurethral Resection of the Prostate: A Feasibility Study

Abstract

Abstract Background Fluid absorption is common in patients undergoing transurethral prostate resections. We aimed to explore the feasibility of using lung ultrasound to monitor fluid overload during and after surgery by detecting extravascular lung water. Methods We conducted a single-center prospective observational study of patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate (TURP) under general anesthesia between December 2020 and August 2021. Lung ultrasound was performed before the operation (T1), 1 h after the surgery started (10 min before the end of the operation if the operation time was < 1 h) (T2), and before leaving the post-anesthesia care unit (PACU, T3) to assess the changes in extravascular lung water. Lung ultrasound scores ≥ 20 were defined as significantly increased extravascular lung water (EVLW). The primary outcome was the incidence of increased EVLW at T3. The secondary outcomes included delayed recovery, postoperative shivering, hypoxemia, time to extubation, time in the PACU, and length of postoperative hospital stay. Results All patients had normal extravascular lung water before surgery, and 6.9% and 35.5% of patients had increased EVLW at T2 and T3, respectively. Increased extravascular lung water prolonged extubation and recovery times. However, postoperative shivering, hypoxemia, and the length of postoperative hospital stay were not significantly affected. Conclusions Lung ultrasound is a reliable noninvasive bedside tool for monitoring fluid absorption during TURP under general anesthesia.