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Pt with advanced Cirrhosis
AKI, Oliguria + Encephalopathy
Initial treatment = Albumin + Lactulose enemas
🧂Na is now 158 (From Lactulose induced free water loss)
#POCUS ninja @tumleal noticed something was wrong! He got his probe and texted me
📱 #WhatsAppAKIConsult 1/5
AKI, Oliguria + Encephalopathy
Initial treatment = Albumin + Lactulose enemas
🧂Na is now 158 (From Lactulose induced free water loss)
#POCUS ninja @tumleal noticed something was wrong! He got his probe and texted me
📱 #WhatsAppAKIConsult 1/5
#POCUS: Plethoric non collapsible IVC
Based on the clinical scenario, IVC, heart rate and Pulse Pressure...
What is the likely underlying pathophysiology? 2/5
Based on the clinical scenario, IVC, heart rate and Pulse Pressure...
What is the likely underlying pathophysiology? 2/5
@tumleal went ahead and confirmed his suspicion:
He 📲texted me this:
LVOT VTI = 38!
Some 🔢:
VTI of 38, assuming a LVOT diameter of 20 mm: Stroke Volume = 119 ml
119 ml x HR (93 bpm) = 11.1 L/min of CO!
This is High Output Heart Failure (Very common in Cirrhosis) 3/5
He 📲texted me this:
LVOT VTI = 38!
Some 🔢:
VTI of 38, assuming a LVOT diameter of 20 mm: Stroke Volume = 119 ml
119 ml x HR (93 bpm) = 11.1 L/min of CO!
This is High Output Heart Failure (Very common in Cirrhosis) 3/5
