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Objectives: To explore the association between lung ultrasound (LUS) and clinical variables in children undergoing cardiopulmonary bypass (CPB)., Methods: A retrospective analysis was conducted in patients weighing <20 kg and with an Aristotle score <9, scanned with LUS on postoperative day (POD) 0, 1 and 2. We defined three LUS profiles: profile A: the prevalence of confluent B lines ("white lung"); profile B: the prevalence of B lines and profile C: the prevalence of A lines (normal lung)., Results: Median (interquartile range [IRQ]) weight, age and Aristotle score were 5.6 kg [IQR 4.0-6.0], 3.2 months [IQR 3.0-7.0] and 6.75 [IQR 6.0-8.0], respectively. No profile A patients were found. At POD1, we identified statistically significant differences between profile B and C patients: CPB time was 157 [IQR138-235] vs 95 [IQR 85-183] minutes ( P  <   0.005); aortic clamp duration was 104 [IQR 87-142] vs 54 [IQR 49-72] minutes ( P  =   0.007); time of mechanical ventilation was 41.5 [IQR 31.0-56.0] vs 15 [IQR 15-24] hours ( P  <   0.001); and ICU length of stay was 2 [IQR 2-3] vs 4 [IQR 3-4] days ( P  =   0.001), respectively. No differences were found between profile B and C patients at all the other time points. No statistically significant differences were found for blood gas values, urine output and fluid balance at all time points., Conclusions: In a small cohort of children undergoing CPB, the LUS profile on POD1 was associated with CPB time, aortic cross-clamp time and mechanical ventilation duration., (© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

We determined if low dose fenoldopam in neonates already receiving conventional diuretics improves urine output, fluid balance, acute kidney injury incidence (AKI) and time to extubation. A prospective controlled clinical trial in a pediatric cardiac intensive care unit on 40 neonates undergoing cardiac surgery with cardiopulmonary bypass, excluding simple ventricular septal defect and atrial septal defect. Fenoldopam was infused at a low dose of 0.1 microg/kg/min soon after anesthesia induction and infusion prolonged for 72 h in 20 patients. Twenty neonates with standardized perioperative therapy except fenoldopam administration served as controls. Demographic, hemodynamic, daily urine output, creatinine, creatinine clearance, serum and urinary sodium and potassium were recorded. Inotropic score (IS) was calculated as a surrogate for the degree of hemodynamic impairment. Low dose fenoldopam infusion did not show beneficial effects in renal function. The treatment did not significantly affect IS value, AKI incidence, fluid balance control, time to sternal closure, time to extubation and time to intensive care unit discharge. Low dose fenoldopam in neonates undergoing cardiac surgery with CPB did not produce effects on urine output, fluid balance and AKI incidence. Fenoldopam was well tolerated and did not negatively affect hemodynamics and vasopressor support.