Point
of care US is increasingly being used in many medical specialties. Nephrology
is catching along swiftly as well. A recent review by our team led by
Ross et al discuss the role of Lung US in the ESRD population. After a systematic review, we concluded that lung US can be used to
determine volume status in chronic ESRD patients by using the B-line score
model( see figure above from paper) as discussed in the paper.
As
nephrologists, we should be using this in practice and help diagnose and
prognosticate high risk patients and perhaps prevent re-admissions.
The role of lung ultrasonography in nephrology practice
requires further research regarding its clinical applications. We stated in our
paper the following amazing ways it can be used in clinical practice..
i.
What
is the role of lung ultrasonography in the management of AKI in the intensive
care unit? Could it be used as an endpoint for continuous renal replacement
therapy?
ii.
Given
the association of mortality with the presence of B-lines in the chronic
dialysis population, what is the role of lung ultrasonography in the management
of the patient on chronic HD? Could B-lines be used to guide need for increased
ultrafiltration and would this change long-term outcome?
iii.
Could
lung ultrasonography be used to guide diuretic therapy in patients with chronic
cardiorenal syndrome?
iv.
As
B-lines detect subclinical volume expansion, could lung ultrasonography be
useful in differentiating hypervolemic from euvolemic hyponatremia?
Where
can one learn to get point of care US training?
The
Emory US course is the mecca of US training: check out the details here
NKF Spring Clinical Meetings 2017 had
a course run by us as a pre-course specifically on point of care US.
Similar course will be prepared for 2018
KidneyCon
2018 will also be having a hands on workshop for Point of care US training
No comments:
Post a Comment