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Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension

Intradialytic hypotension (IDH) is a frequent and well-known complication of hemodialysis, occurring in about one third of patients. An integrated approach with different methods is needed to minimize IDH episodes and their complications. In this prospective observational study, recruited patients u...

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Autores principales: Allinovi, Marco, Palazzini, Giulia, Lugli, Gianmarco, Gianassi, Iacopo, Dallari, Lorenzo, Laudicina, Selene, Gregori, Marco, Rossi, Francesco, Giannerini, Daniele, Cutruzzulà, Roberta, Dervishi, Egrina, Biagini, Maria, Cirami, Calogero Lino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776885/
https://www.ncbi.nlm.nih.gov/pubmed/36552997
http://dx.doi.org/10.3390/diagnostics12122990
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author Allinovi, Marco
Palazzini, Giulia
Lugli, Gianmarco
Gianassi, Iacopo
Dallari, Lorenzo
Laudicina, Selene
Gregori, Marco
Rossi, Francesco
Giannerini, Daniele
Cutruzzulà, Roberta
Dervishi, Egrina
Biagini, Maria
Cirami, Calogero Lino
author_facet Allinovi, Marco
Palazzini, Giulia
Lugli, Gianmarco
Gianassi, Iacopo
Dallari, Lorenzo
Laudicina, Selene
Gregori, Marco
Rossi, Francesco
Giannerini, Daniele
Cutruzzulà, Roberta
Dervishi, Egrina
Biagini, Maria
Cirami, Calogero Lino
author_sort Allinovi, Marco
collection PubMed
description Intradialytic hypotension (IDH) is a frequent and well-known complication of hemodialysis, occurring in about one third of patients. An integrated approach with different methods is needed to minimize IDH episodes and their complications. In this prospective observational study, recruited patients underwent a multiparametric evaluation of fluid status through a lung ultrasound (LUS) with the quantification of B-lines, a physical examination, blood pressure, NT-proBNP and chest X-rays. The evaluation took place immediately before and at the end of the dialysis session, and the patients were divided into IDH and no-IDH groups. We recruited a total of 107 patients. A pre-dialysis B-line number ≥ 15 showed a high sensitivity in fluid overload diagnosis (94.5%), even higher than a chest X-ray (78%) or physical examination (72%) alone. The identification at the beginning of dialysis of <8 B-lines in the overall cohort or <20 B-lines in patients with NYHA 3–4 class are optimal thresholds for identifying those patients at higher risk of experiencing an IDH episode. In the multivariable analysis, the NYHA class, a low pre-dialysis systolic BP and a low pre-dialysis B-line number were independent risk factors for IDH. At the beginning of dialysis, the B-line quantification at LUS is a valuable and reliable method for evaluating fluid status and predicting IDH episodes. A post-dialysis B-line number <5 may allow for an understanding of whether the IDH episode was caused by dehydration, probably due to due to an overestimation of the dry weight.
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spelling pubmed-97768852022-12-23 Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension Allinovi, Marco Palazzini, Giulia Lugli, Gianmarco Gianassi, Iacopo Dallari, Lorenzo Laudicina, Selene Gregori, Marco Rossi, Francesco Giannerini, Daniele Cutruzzulà, Roberta Dervishi, Egrina Biagini, Maria Cirami, Calogero Lino Diagnostics (Basel) Article Intradialytic hypotension (IDH) is a frequent and well-known complication of hemodialysis, occurring in about one third of patients. An integrated approach with different methods is needed to minimize IDH episodes and their complications. In this prospective observational study, recruited patients underwent a multiparametric evaluation of fluid status through a lung ultrasound (LUS) with the quantification of B-lines, a physical examination, blood pressure, NT-proBNP and chest X-rays. The evaluation took place immediately before and at the end of the dialysis session, and the patients were divided into IDH and no-IDH groups. We recruited a total of 107 patients. A pre-dialysis B-line number ≥ 15 showed a high sensitivity in fluid overload diagnosis (94.5%), even higher than a chest X-ray (78%) or physical examination (72%) alone. The identification at the beginning of dialysis of <8 B-lines in the overall cohort or <20 B-lines in patients with NYHA 3–4 class are optimal thresholds for identifying those patients at higher risk of experiencing an IDH episode. In the multivariable analysis, the NYHA class, a low pre-dialysis systolic BP and a low pre-dialysis B-line number were independent risk factors for IDH. At the beginning of dialysis, the B-line quantification at LUS is a valuable and reliable method for evaluating fluid status and predicting IDH episodes. A post-dialysis B-line number <5 may allow for an understanding of whether the IDH episode was caused by dehydration, probably due to due to an overestimation of the dry weight. MDPI 2022-11-29 /pmc/articles/PMC9776885/ /pubmed/36552997 http://dx.doi.org/10.3390/diagnostics12122990 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Allinovi, Marco
Palazzini, Giulia
Lugli, Gianmarco
Gianassi, Iacopo
Dallari, Lorenzo
Laudicina, Selene
Gregori, Marco
Rossi, Francesco
Giannerini, Daniele
Cutruzzulà, Roberta
Dervishi, Egrina
Biagini, Maria
Cirami, Calogero Lino
Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension
title Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension
title_full Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension
title_fullStr Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension
title_full_unstemmed Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension
title_short Pre-Dialysis B-Line Quantification at Lung Ultrasound Is a Useful Method for Evaluating the Dry Weight and Predicting the Risk of Intradialytic Hypotension
title_sort pre-dialysis b-line quantification at lung ultrasound is a useful method for evaluating the dry weight and predicting the risk of intradialytic hypotension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776885/
https://www.ncbi.nlm.nih.gov/pubmed/36552997
http://dx.doi.org/10.3390/diagnostics12122990
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