Lung Ultrasound Predicts Pulmonary Complications: Reply

Le résumé fourni par la source

We would like to thank Stéphane Bar and his team for their interesting comments,1 which shed important light on our findings and those previously published on the subject.As stated in our article,2 we confirm that our work is not seminal in uncovering a correlation between the postoperative lung ultrasound score in major abdominal surgery and the occurrence of postoperative pulmonary complications.3–5 In the context of a pragmatic study in the intensive care unit, we were unable to carry an “immediate” approach consisting in performing lung ultrasound as soon as possible after surgery3,5,6 for a number of logistical reasons; however, we remain firmly convinced of its usefulness, in particular in ensuring that lung ultrasound predictive power is not confounded with its diagnostic value, and in enabling the earliest possible implementation of intensive preventive bundles. Regarding the margin for improvement of the practicality of the lung ultrasound scoring, the 4-point score proposed by Bar et al.5 is even more streamlined than our simplified anterolateral score (4 vs. 8 investigated areas, respectively). This is particularly significant as the most gravity-dependent lung areas are perhaps the least informative, since they are most often the site of nonspecific loss of aeration, whereas the non–gravity-dependent areas are potentially the most discriminating.We read with great interest Bar’s idea of combining rapid scoring at the end of surgery and/or in the post-anesthesia care unit with the lung ultrasound score in the intensive care unit—or more comprehensive version of it—which could greatly improve patients’ coordinated healthcare circuit. Yet, the feasibility of this dual approach, which requires trained operators and rapid logistical availability at the end of surgery, as well as its contribution to improving predictive accuracy, remain to be explored.Finally, we concur with Bar et al. in their call for clinicians to use lung ultrasound, a fantastic, powerful, and noninvasive bedside tool, to identify patients most at risk of postoperative pulmonary complications as early as possible in their postoperative course and help improve their outcomes.The authors declare no competing interests.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.