Volume Assessment in Hemodialysis: A Comparison of Present Methods in Clinical Practice with Sonographic Lung Comets
| Autor: | N D Srinivasaprasad, Sujit Suren, A M Veerakumar, M Edwin Fernando, K Thirumalvalavan, Ishwarya Annamalai, Suhasini Balasubramaniam |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Nephrology
High-resolution computed tomography medicine.medical_specialty medicine.medical_treatment high-resolution computed tomography 030232 urology & nephrology 030230 surgery lcsh:RC870-923 Inferior vena cava 03 medical and health sciences 0302 clinical medicine B lines Internal medicine medicine Intravascular volume status Dialysis lung ultrasound Lung hemodialysis medicine.diagnostic_test business.industry lcsh:Diseases of the genitourinary system. Urology respiratory tract diseases medicine.anatomical_structure medicine.vein Crackles Original Article Hemodialysis Radiology medicine.symptom business |
| Zdroj: | Indian Journal of Nephrology Indian Journal of Nephrology, Vol 29, Iss 2, Pp 102-110 (2019) |
| ISSN: | 1998-3662 0971-4065 |
| Popis: | Dry weight assessment in dialysis patients remains a challenging endeavor owing to the limitations of the available methods for volume assessment. Lung ultrasound is emerging as an invaluable tool to assist in the appropriate assessment and assignment of dry weight. The objectives of this study are (1) to determine the reliability of clinical signs and symptoms for volume assessment, (2) to compare lung ultrasound with High Resolution Computed Tomography (HRCT) chest-A noninvasive gold standard tool for detecting pulmonary congestion and with inferior vena cava diameter (IVCD) - another time-tested volume assessment method, and (3) to analyze if lung ultrasound could detect dialysis induced fluid status variations. The cross-sectional study involves 50 patients on maintenance hemodialysis. Lung ultrasound for B line estimation and ultrasonographic measurement of IVCD performed before and after hemodialysis by a nephrologist trained in ultrasonography. Limited HRCT was obtained just before hemodialysis. Edema, crackles, and dyspnea had a poor sensitivity of 37.9%, 11.5%, and 52.6%, respectively, to detect clinically significant pulmonary congestion by lung ultrasound. A highly significant correlation was obtained between B-line score and HRCT signs of pulmonary congestion (P < 0.001) before dialysis. B lines showed statistically significant reduction with dialysis. The absolute reduction of B lines showed significant correlation with ultrafiltration volume and weight loss. Bedside lung ultrasound appears a sensitive tool for evaluating real-time changes in extravascular lung water and would serve to optimize volume status in dialysis patients. |
| Databáze: | OpenAIRE |
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