Hussam K. Hamadah
Ministry of National Guard, Health Affairs Riyadh, Kingdom of Saudi Arabia
Title: Ultrasound for diaphragmatic dysfunction in postoperative cardiac children
Biography
Biography: Hussam K. Hamadah
Abstract
Introduction: Diaphragmatic Dysfunction is a common cause of failed extubation and prolonged mechanical ventilation after pediatric cardiac surgery in up to 14%. This study aims to evaluate the role of critical care bedside Ultrasound performed by intensivist to diagnose diaphragmatic dysfunction and the need for plication after pediatric cardiac surgery. Methods: Retrospective cohort study on prospectively collected data for post-operative children admitted to PCICU during 2015. Diaphragmatic dysfunction was suspected based on difficulties in weaning from positive pressure ventilation or Chest X-Ray findings. Ultrasound studies were performed by PCICU intensivist and confirmed by qualified radiologist. Results: Out of 344 post-operative patients, 32 needed diaphragm ultrasound for suspected dysfunction. Ultrasound confirmed diaphragmatic dysfunction in17/32 (53%) patients with an average age and weight of (10.8±3.8) months and (6±1) Kg respectively. The incidence rate of diaphragmatic dysfunction was (4.9%) in relation to the whole population. Diaphragmatic plication was needed in 9/17 cases (53%), with rate of 2.6% in post-operative cardiac children. Mean plication day was (15.1±1.3) after surgery. All patients who underwent plication were under 4 months of age. Post plication they were discharged with mean Pediatric CICU and hospital stay of (19±3.5) and (42±8) days respectively. Conclusions: Critical care ultrasound assessment of diaphragmatic movement is a useful and practical bedside tool that can be performed by a trained pediatric (CICU) intensivist. It may help in early detection and management of diaphragmatic dysfunction post pediatric cardiac surgery which may have potential positive effect on morbidity and outcome.
Recent Publications:
1. Ultrasound guided post-pyloric feeding tube insertion in peri-operative cardiac infants. Hamadah HK et al (2021). Cardiology in the Young. 2021 Oct 14:1-4.
2. Surgical outcome of Yasui procedure for preserving biventricular function: single centre experience. Alhadi O, Kabbani MS, Alhabshan F, Alamer M, Alomrani A, Hamadah H. Cardiol Young. 2021 Nov 15:1-5.
3. Outcome of truncus arteriosus repair: 20 years of single-center experience comparing early versus late surgical repair. Hrfi A, Ismail M, Mohammed MHA, Hamadah HK, Alhabshan F, Abu-Sulaiman R, Kabbani MS. Cardiol Young. 2021 Oct 20:1-7.
4. Aortopulmonary window: Types, associated cardiovascular anomalies, and surgical outcome. Retrospective analysis of a single center experience. Bin-Moallim Mohammed, Hussam K. Hamadah, et al. Saudi Heart Assoc. 2020 May 10;32(2):127-133.
5. Predictors of Reopening the Sternum in Children After Cardiac Surgery. Ghassan A. Shaath,1; Abdulraouf M. Z. Jijeh,1; Sameh R. Ismail,1; Omar Hijazi,1; Riyadh Abu Sulaiman, 1,2; Wedad Almadani, 2; Mohammed Husam Hamadah,1; Hani K. Najm, 1; Mohamed S. Kabbani, Pediatr Crit Care Med. 2020 Mar;21(3):235-239.