All nephrologists should be learning #POCUS now. It is safe, reproducible, cheap!!! Some uses are:
1. Rule out obstruction
2. Dx cause of hemodynamic inestability
3. To guide vascular access
@WBeaubien #KidneyWk
1. Rule out obstruction
2. Dx cause of hemodynamic inestability
3. To guide vascular access
@WBeaubien #KidneyWk
Beyon the basic applications in #AKI
1. Assessment of kidney perfussion
2. Detection of early AKI
3. Prediction ofpersistent AKI
4. Detect kidney congestion
2D US is ok, but using other modalities like doppler we can get more granular data on kidney hemodynamics.
#kidneywk
1. Assessment of kidney perfussion
2. Detection of early AKI
3. Prediction ofpersistent AKI
4. Detect kidney congestion
2D US is ok, but using other modalities like doppler we can get more granular data on kidney hemodynamics.
#kidneywk
However using only color doppler or power doppler is not good enough. #KidneyWk
Enter pulse doppler. It allows us to assess blood flow velocity at specific points. We all are familiar with resistive index from the transplant world. However it is far from perfect and maybe not usefult to predict AKI. #KidenyWk
However, with pulse doppler we may also assess venous circulation. The venous wave forms change accordingly to the level of venous congestion #Kidneywk
We may assess several veins: hepatic, portal, renal and of course IVC #KidenyWk
These patterns can be used to assess kidney perfussion. Validated in congestive heart failure and cardiac surgery. Not yet validated in patients unselected ICU patients #Kidneywk
The #VEXUS score was designed as a quantifying system of systemic venous congestion. Very specific for AKI after cardiac surgery, performed better than CVP #Kidenywk
Other modalities : Elastography and contrast enhanced US. Not ready for prime time. The futer is bright for #POCUS #KidneyWk
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