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POCUS in Intensive Care Nephrology

Acute kidney injury (AKI) is a significant problem for patients admitted to the intensive care unit (ICU), both due to the high incidence and associated mortality with rates of AKI requiring renal replacement therapy (RRT) of over 5%, and mortality rates with AKI of over 60% 1, 2.Ultrasound can be u...

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Autores principales: Connor­-Schuler, Randi, Suarez, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994305/
https://www.ncbi.nlm.nih.gov/pubmed/36896116
http://dx.doi.org/10.24908/pocus.v7iKidney.15016
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author Connor­-Schuler, Randi
Suarez, Jonathan
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Suarez, Jonathan
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description Acute kidney injury (AKI) is a significant problem for patients admitted to the intensive care unit (ICU), both due to the high incidence and associated mortality with rates of AKI requiring renal replacement therapy (RRT) of over 5%, and mortality rates with AKI of over 60% 1, 2.Ultrasound can be used to identify those at risk for AKI and assist with AKI management. Risk factors for AKI in the ICU not only include hypoperfusion but also venous congestion and volume overload. Volume overload and vascular congestion are associated with multi-organ dysfunction and worse renal outcomes. Daily and overall fluid balance, daily weights, and physical examination for edema can be inaccurate and belie true systemic venous pressure 3, 4, 5. Bedside ultrasound allows providers to evaluate vascular flow patterns and obtain a more reliable evaluation of volume status to guide and individualize therapies. Cardiac, lung, and vascular patterns on ultrasound can identify preload responsiveness, which should be assessed to safely manage ongoing fluid resuscitation and assess for signs of fluid intolerance. Here we present an overview in the use of point of care ultrasound with particular emphasis on nephro-centric strategies, namely in the identification of the type of renal injury, renal vascular flow assessment, the static measure of volume status, as well as dynamic evaluation for volume optimization in critically ill patients.
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spelling pubmed-99943052023-03-08 POCUS in Intensive Care Nephrology Connor­-Schuler, Randi Suarez, Jonathan POCUS J Medicine Acute kidney injury (AKI) is a significant problem for patients admitted to the intensive care unit (ICU), both due to the high incidence and associated mortality with rates of AKI requiring renal replacement therapy (RRT) of over 5%, and mortality rates with AKI of over 60% 1, 2.Ultrasound can be used to identify those at risk for AKI and assist with AKI management. Risk factors for AKI in the ICU not only include hypoperfusion but also venous congestion and volume overload. Volume overload and vascular congestion are associated with multi-organ dysfunction and worse renal outcomes. Daily and overall fluid balance, daily weights, and physical examination for edema can be inaccurate and belie true systemic venous pressure 3, 4, 5. Bedside ultrasound allows providers to evaluate vascular flow patterns and obtain a more reliable evaluation of volume status to guide and individualize therapies. Cardiac, lung, and vascular patterns on ultrasound can identify preload responsiveness, which should be assessed to safely manage ongoing fluid resuscitation and assess for signs of fluid intolerance. Here we present an overview in the use of point of care ultrasound with particular emphasis on nephro-centric strategies, namely in the identification of the type of renal injury, renal vascular flow assessment, the static measure of volume status, as well as dynamic evaluation for volume optimization in critically ill patients. 2022-02-01 /pmc/articles/PMC9994305/ /pubmed/36896116 http://dx.doi.org/10.24908/pocus.v7iKidney.15016 Text en Copyright (c) 2022 Randi Connor-Schuler, Jonathan Suarez https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Medicine
Connor­-Schuler, Randi
Suarez, Jonathan
POCUS in Intensive Care Nephrology
title POCUS in Intensive Care Nephrology
title_full POCUS in Intensive Care Nephrology
title_fullStr POCUS in Intensive Care Nephrology
title_full_unstemmed POCUS in Intensive Care Nephrology
title_short POCUS in Intensive Care Nephrology
title_sort pocus in intensive care nephrology
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994305/
https://www.ncbi.nlm.nih.gov/pubmed/36896116
http://dx.doi.org/10.24908/pocus.v7iKidney.15016
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