Evaluation of Subclinical Fluid Overload Using Lung Ultrasound and Estimated Plasma Volume in the Postoperative Period Following Kidney Transplantation

Mottola, Clément; Girerd, Nicolas; Coiro, Stefano; Lamiral, Zohra; Rossignol, Patrick; Frimat, Luc; Girerd, Sophie

doi:10.1016/j.transproceed.2018.03.007

Cited by 12 publications

(9 citation statements)

References 34 publications

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“…Several diagnostic and management strategies for prevention, early diagnosis, and treatment of FO have been previously studied and may be relevant to our population. Lung ultrasound is an inexpensive, low risk, highly accessible method shown to be effective in quantifying extravascular lung volume in patients at risk for pulmonary edema . Conservative, net‐neutral, fluid balance strategies have been successful in a number of pediatric patient populations, including stem cell transplant recipients, ARDS patients, and post‐resuscitation sepsis patients .…”

Section: Discussionmentioning

confidence: 99%

“…Lung ultrasound is an inexpensive, low risk, highly accessible method shown to be effective in quantifying extravascular lung volume in patients at risk for pulmonary edema. 45,46 Conservative, net-neutral, fluid balance strategies have been successful in a number of pediatric patient populations, including stem cell transplant recipients, 35 ARDS patients, 34,43 and post-resuscitation sepsis patients. 34,43 In a meta-analysis of 11 randomized trials incorporating conservative versus standard/liberal fluid strategies in the post-resuscitative care of adults and children with ARDS, sepsis, or systemic inflammatory response syndrome, a conservative strategy was associated with increased ventilator-free days and decreased ICU stay.…”

Section: Discussionmentioning

confidence: 99%

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Impact of fluid overload and infection on respiratory adverse event development during induction therapy for childhood acute myeloid leukemia

Miller

Keller

Mertens

et al. 2019

Pediatric Blood & Cancer

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Background Treatment‐related morbidity and mortality occur frequently in childhood acute myeloid leukemia (AML) induction. Yet the contributions of respiratory adverse events (AEs) within this population are poorly understood. Furthermore, the roles of fluid overload (FO) and infection in AML pulmonary complications have been inadequately examined. Objectives To describe the incidence, categories, and grades of respiratory AEs and to assess the associations of FO and infection on respiratory AE development in childhood AML induction. Methods We retrospectively examined the induction courses of a cohort of de novo pediatric AML patients for any NCI CTCAE grade 2 to 5 respiratory AE, FO, and systemic/pulmonary infection occurrence. Demographic, disease, and treatment‐related data were abstracted. Descriptive, univariate, survival, and multivariable analyses were conducted. Results Among 105 eligible subjects from 2009 to 2016, 49.5% (n = 52) experienced 63 discrete respiratory AEs. FO occurred in 28.6% of subjects (n = 30), with half occurring within 24 hours of hospitalization. Positive FO status < 10 days (aHR 5.5, 95% CI 2.3‐12.8), ≥ 10 days (aHR 13, 95% CI 4.1‐41.8), and positive infection status ≥ 10 days into treatment (aHR 14.9, 5.4‐41.6) were each independently associated with AE development. Conclusions We describe a higher incidence of respiratory AEs during childhood AML induction than previously illustrated. FO occurs frequently and early in this course. Late infections and FO at any time frame were strongly associated with AE development. Interventions focused on the prevention and management of FO and infectious respiratory complications could be instrumental in reducing preventable treatment‐related morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of fluid overload and infection on respiratory adverse event development during induction therapy for childhood acute myeloid leukemia

Miller

Keller

Mertens

et al. 2019

Pediatric Blood & Cancer

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“…Experts’ comments [ 66 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 ]: Studies concerning dialysis patients most frequently follow the protocol of assessing 28 scans of the anterolateral chest, adapted from cardiologic examinations. The interpretation of the examination results is sometimes modified by resigning from the notion of “mild congestion”.…”

Section: Recommendationsmentioning

confidence: 99%

Recommendations for Lung Ultrasound in Internal Medicine

et al. 2020

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A growing amount of evidence prompts us to update the first version of recommendations for lung ultrasound in internal medicine (POLLUS-IM) that was published in 2018. The recommendations were established in several stages, consisting of: literature review, assessment of literature data quality (with the application of QUADAS, QUADAS-2 and GRADE criteria) and expert evaluation carried out consistently with the modified Delphi method (three rounds of on-line discussions, followed by a secret ballot by the panel of experts after each completed discussion). Publications to be analyzed were selected from the following databases: Pubmed, Medline, OVID, and Embase. New reports published as of October 2019 were added to the existing POLLUS-IM database used for the original publication of 2018. Altogether, 528 publications were systematically reviewed, including 253 new reports published between September 2017 and October 2019. The new recommendations concern the following conditions and issues: pneumonia, heart failure, monitoring dialyzed patients’ hydration status, assessment of pleural effusion, pulmonary embolism and diaphragm function assessment. POLLUS-IM 2020 recommendations were established primarily for clinicians who utilize lung ultrasound in their everyday clinical work.

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“…Plasma volume (PV), on the other hand, expresses the intravascular portion of the extracellular fluid volume, and is estimated from hemoglobin/hematocrit levels (12)(13)(14). Its estimation (estimated plasma volume status, ePVS) has been associated with left ventricular (LV) filling pressure (i.e., E/e' and invasively-measured LV end-diastolic pressure) (15) and with pulmonary congestion (16). Recent published reports showed that ePVS and CSI were associated with clinical outcomes in several HF settings (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

A Combination of Chest Radiography and Estimated Plasma Volume May Predict In-Hospital Mortality in Acute Heart Failure

Kobayashi

Douair

Coiro

et al. 2022

Front. Cardiovasc. Med.

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Background: Patients with heart failure (HF) often display dyspnea associated with pulmonary congestion, along with intravascular congestion, both may result in urgent hospitalization and subsequent death. A combination of radiographic pulmonary congestion and plasma volume might screen patients with a high risk of in-hospital mortality in the emergency department (ED).Methods: In the pathway of dyspneic patients in emergency (PARADISE) cohort, patients admitted for acute HF were stratified into 4 groups based on high or low congestion score index (CSI, ranging from 0 to 3, high value indicating severe congestion) and estimated plasma volume status (ePVS) calculated from hemoglobin/hematocrit.Results: In a total of 252 patients (mean age, 81.9 years; male, 46.8%), CSI and ePVS were not correlated (Spearman rho <0 .10, p > 0.10). High CSI/high ePVS was associated with poorer renal function, but clinical congestion markers (i.e., natriuretic peptide) were comparable across CSI/ePVS categories. High CSI/high ePVS was associated with a four-fold higher risk of in-hospital mortality (adjusted-OR, 95%CI = 4.20, 1.10-19.67) compared with low CSI/low ePVS, whereas neither high CSI nor ePVS alone was associated with poor prognosis (all-p-value > 0.10; Pinteraction = 0.03). High CSI/high ePVS improved a routine risk model (i.e., natriuretic peptide and lactate)(NRI = 46.9%, p = 0.02), resulting in high prediction of risk of in-hospital mortality (AUC = 0.85, 0.82-0.89).Conclusion: In patients hospitalized for acute HF with relatively old age and comorbidity burdens, a combination of CSI and ePVS was associated with a risk of in-hospital death, and improved prognostic performance on top of a conventional risk model.

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Evaluation of Subclinical Fluid Overload Using Lung Ultrasound and Estimated Plasma Volume in the Postoperative Period Following Kidney Transplantation

Cited by 12 publications

References 34 publications

Impact of fluid overload and infection on respiratory adverse event development during induction therapy for childhood acute myeloid leukemia

Impact of fluid overload and infection on respiratory adverse event development during induction therapy for childhood acute myeloid leukemia

Recommendations for Lung Ultrasound in Internal Medicine

A Combination of Chest Radiography and Estimated Plasma Volume May Predict In-Hospital Mortality in Acute Heart Failure

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