Volume Assessment in Hemodialysis: A Comparison of Present Methods in Clinical Practice with Sonographic Lung Comets

被引:10
|
作者
Annamalai, Ishwarya [1 ]
Balasubramaniam, Suhasini [2 ]
Fernando, M. Edwin [1 ]
Srinivasaprasad, N. D. [1 ]
Suren, S. [1 ]
Thirumalvalavan, K. [1 ]
Veerakumar, A. M. [3 ]
机构
[1] Govt Stanley Hosp, Dept Nephrol, Chennai, Tamil Nadu, India
[2] Govt Stanley Hosp, Dept Radiol, Old Jail Rd, Chennai 600001, Tamil Nadu, India
[3] Govt Stanley Hosp, Dept Community Med, Chennai, Tamil Nadu, India
关键词
B lines; hemodialysis; high-resolution computed tomography; lung ultrasound; FLUID STATUS ASSESSMENT; PULMONARY CONGESTION; CHEST ULTRASOUND; MORTALITY; WEIGHT; WATER;
D O I
10.4103/ijn.IJN_78_18
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:102 / 110
页数:9
相关论文
共 50 条
  • [21] Evaluation and Comparison of Sonographic Difficult Airway Assessment Parameters with Clinical Airway Predictors
    Kumar, Mritunjay
    Anushaprasath, U.
    Kamal, Manoj
    Bhatia, Pradeep
    Kaloria, Narender
    Paliwal, Bharat
    Gupta, Sunit Kumar
    Mohammed, Sadik
    Sharma, Ankur
    ANESTHESIA AND ANALGESIA, 2024, 139 (06): : 26 - 28
  • [22] A Comparison of Two Methods for Assessment of Lung Mechanical Parameters
    Palko, Krzysztof Jakub
    BIOCYBERNETICS AND BIOMEDICAL ENGINEERING, 2009, 29 (03) : 19 - 30
  • [23] Impact of Clinical Trials on Neurosurgical Practice: An Assessment of Case Volume
    Simon, Scott D.
    Koyama, Tatsuki
    Zacharia, Brad E.
    Schirmer, Clemens M.
    Cheng, Joseph S.
    WORLD NEUROSURGERY, 2015, 83 (04) : 431 - 437
  • [24] ASSESSMENT OF RELAXATION IN CLINICAL PRACTICE - METHODS FOR ROUTINE AND RESEARCH
    STOVNER, J
    HOLSTLARSEN, H
    HARBOE, S
    UPSALA JOURNAL OF MEDICAL SCIENCES, 1977, : 2 - 2
  • [25] Arteriosclerosis and atherosclerosis assessment in clinical practice: Methods and significance
    Park, Jeong Bae
    Avolio, Alberto
    PULSE, 2023, 11 (01) : 1 - 8
  • [26] ASSESSMENT OF RELAXATION IN CLINICAL PRACTICE - METHODS FOR ROUTINE AND RESEARCH
    STOVNER, J
    HOLSTLARSEN, H
    HARBO, S
    ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1978, : 103 - 105
  • [27] A COMPARISON OF FORCED EXPIRATORY VOLUME AND PEAK FLOW IN CLINICAL PRACTICE
    RITCHIE, B
    LANCET, 1962, 2 (7250): : 271 - &
  • [28] Evaluation and comparison of sonographic difficult airway assessment parameters with clinical airway predictors
    Anushaprasath, U.
    Kumar, Mritunjay
    Kamal, Manoj
    Bhatia, Pradeep
    Kaloria, Narendra
    Paliwal, Bharat
    Gupta, Sunit Kumar
    Mohammed, Sadik
    Sharma, Ankur
    JOURNAL OF ANAESTHESIOLOGY CLINICAL PHARMACOLOGY, 2024, 40 (03) : 422 - 431
  • [29] A Simple and Feasible Method to Determine Absolute Blood Volume in Hemodialysis Patients in Clinical Practice
    Kron, Joachim
    Schneditz, Daniel
    Leimbach, Til
    Aign, Sabine
    Kron, Susanne
    BLOOD PURIFICATION, 2014, 38 (3-4) : 180 - 187
  • [30] EXERCISE TESTING IN ASSESSMENT AND MANAGEMENT OF PATIENTS IN CLINICAL PRACTICE - PRESENT SITUATION
    Choudhary, Sumer S.
    Choudhary, Sanjiw
    LUNG INDIA, 2008, 25 (03) : 111 - 117