Use of Ultrasound to Assess Hemodynamics in Acutely Ill Patients

Safadi, Sami; Murthi, Sarah B.; Kashani, Kianoush

doi:10.34067/kid.0002322021

Cited by 10 publications

(7 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As mentioned above, a global POCUS physical examination of patients in shock can determine fundamental hemodynamic measures ( e.g ., stroke volume, cardiac contractility, and valvular diseases). In addition, POCUS can assess organ congestion and fluid tolerance (76).…”

Section: Point-of-care Ultrasonography In Fluid Status Assessmentmentioning

confidence: 99%

“…This changes with a progressive increase in kidney intracapsular pressure and congestion. In mild to moderate congestion, pulsatile intrarenal venous flow is biphasic, becoming monophasic with progressive congestion (76).…”

Section: Point-of-care Ultrasonography In Fluid Status Assessmentmentioning

confidence: 99%

“…Figure 3. | Venous flow patterns and organ congestion(76). Normal hepatic venous flow patterns should have a flow wave larger in systole than in diastole.…”

mentioning

confidence: 99%

See 2 more Smart Citations

The Intensivist's Perspective of Shock, Volume Management, and Hemodynamic Monitoring

Kashani

Omer

Shaw

2022

CJASN

Self Cite

View full text Add to dashboard Cite

One of the primary reasons for intensive care admission is shock. Identifying the underlying cause of shock (hypovolemic, distributive, cardiogenic, and obstructive) may lead to entirely different clinical pathways for management. Among patients with hypovolemic and distributive shock, fluid therapy is one of the leading management strategies. Although an appropriate amount of fluid administration might save a patient's life, inadequate (or excessive) fluid use could lead to more complications, including organ failure and mortality due to either hypovolemia or volume overload. Currently, intensivists have access to a wide variety of information sources and tools to monitor the underlying hemodynamic status, including medical history, physical examination, and specific hemodynamic monitoring devices. Although appropriate and timely assessment and interpretation of this information can promote adequate fluid resuscitation, misinterpretation of these data can also lead to additional mortality and morbidity. This article provides a narrative review of the most commonly used hemodynamic monitoring approaches to assessing fluid responsiveness and fluid tolerance. In addition, we describe the benefits and disadvantages of these tools.

show abstract

Section: Point-of-care Ultrasonography In Fluid Status Assessmentmentioning

confidence: 99%

Section: Point-of-care Ultrasonography In Fluid Status Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

The Intensivist's Perspective of Shock, Volume Management, and Hemodynamic Monitoring

Kashani

Omer

Shaw

2022

CJASN

Self Cite

View full text Add to dashboard Cite

show abstract

“…American Society of Echocardiography (ASE) recommends the patient's supine position to assess IVC diameter as it is directly affected. 18 All studies in our https://doi.org/10.2147/MDER.S454849…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Non-Invasive Parameters (Inferior Vena Cava Diameter, Inferior Vena Cava Collapsibility, Inferior Vena Cava-Aortic Ratio) for Hemodynamic Monitoring in Critically Ill Children: A Systematic Review

Hakim,

Meilyana,

Peryoga

et al. 2024

MDER

View full text Add to dashboard Cite

Volume measurement in critically ill children can be conducted using invasive procedure such as Central Venous Pressure (CVP), or non-invasive procedure such as measurement of Inferior Vena Cava (IVC) indices using ultrasonography. However, their accuracy and efficacy are still under scrutiny. We aim to compare CVP and IVC indices as non-invasive parameters in assessing volume status in critically ill children. Methods: We conducted a systematic review based on literature searching from four electronic databases which were PubMed, Cochrane, ScienceDirect, SpringerLink with keywords: "CENTRAL VENOUS PRESSURE", "INFERIOR VENA CAVA DIAMETER", "INFERIOR VENA CAVA COLLAPSIBILITY", "INFERIOR VENA CAVA AORTIC-RATIO", "VOLUME STATUS", "FLUID STATUS", "CRITICAL ILL", "CHILDREN", and "PEDIATRICS". We included relevant studies in English published from 2000 to 2023 on critically ill children aged 0-18 years. Comparison between CVP and IVC indices was resumed. Results: Eight articles were included in this study. Majority of the studies showed a consistent correlation between CVP and IVC indices. IVC-CI was the most common parameter evaluated in the included studies. There was moderate to strong correlations using IVC-CI and IVC-DI, and moderate correlation using IVC-Ao ratio. Conclusion:We found that non-invasive tools might have a potential role to measure volume in critically ill children equals to CVP. Further high-quality and longitudinal studies are needed to validate these findings and to establish a clear guideline for the noninvasive tool to be used in daily clinical practice.

show abstract

“…Evaluation of Doppler‐derived kidney venous‐flow (KVF) waveforms is an accepted noninvasive method to assess congestion. 9 , 10 Congestion‐associated increases in the hydrostatic pressure of the kidney interstitium disrupt the continuity of intrakidney venous flow (IKVF), which changes from pulsatile to biphasic to monophasic with progressive congestion. 10 We recently proposed the use of the kidney venous stasis index (KVSI) as a continuous indicator to reflect the full continuum of kidney congestion.…”

mentioning

confidence: 99%

Changes in Doppler‐Derived Kidney Venous Flow and Adverse Cardiorenal Outcomes in Patients With Heart Failure

Husain‐Syed

Singam

Viehman

et al. 2023

JAHA

Self Cite

View full text Add to dashboard Cite

Background The impact of changes in Doppler‐derived kidney venous flow in heart failure (HF) is not well studied. We aimed to investigate the association of Doppler‐derived kidney venous stasis index (KVSI) and intrakidney venous‐flow (IKVF) patterns with adverse cardiorenal outcomes in patients with HF. Methods and Results In this observational cohort study, consecutive inpatients with HF referred to a nephrologist because of a history of diuretic resistance and abnormal kidney function (n=216) underwent spectral kidney assessments after admission (Doppler 1) and 25 to 35 days later (Doppler 2) to identify IKVF patterns (continuous/pulsatile/biphasic/monophasic) and KVSI levels. Cox proportional hazard regression models were used to evaluate the associations between KVSI/IKVF patterns at Doppler 1 as well as changes from Doppler 1 to Doppler 2 and risk of cardiorenal events up to 18 months after admission. Worsening HF or death occurred in 126 patients. Both baseline KVSI (hazard ratio [HR], 1.49 [95% CI, 1.37–1.61] per 0.1‐unit increase) and baseline IKVF pattern (HR, 2.47 [95% CI, 2.01–3.04] per 1 pattern severity increase) were significantly associated with worsening HF/death. Increases in both KVSI and IKVF pattern severity from Doppler 1 to 2 were also associated with an increased risk of worsening HF/death (HR, 3.00 [95% CI, 2.08–4.32] per 0.1‐unit increase change; and HR, 6.73 [95% CI, 3.27–13.86] per 1 pattern increase in severity change, respectively). Similar results were observed for kidney outcomes. Conclusions Baseline kidney venous flow predicted adverse cardiorenal events, and inclusion of serial kidney venous flow in cardiorenal risk stratification could facilitate clinical decision‐making for patients with HF. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03039959.

show abstract

Use of Ultrasound to Assess Hemodynamics in Acutely Ill Patients

Cited by 10 publications

References 45 publications

The Intensivist's Perspective of Shock, Volume Management, and Hemodynamic Monitoring

The Intensivist's Perspective of Shock, Volume Management, and Hemodynamic Monitoring

Usefulness of Non-Invasive Parameters (Inferior Vena Cava Diameter, Inferior Vena Cava Collapsibility, Inferior Vena Cava-Aortic Ratio) for Hemodynamic Monitoring in Critically Ill Children: A Systematic Review

Changes in Doppler‐Derived Kidney Venous Flow and Adverse Cardiorenal Outcomes in Patients With Heart Failure

Contact Info

Product

Resources

About