Variables associated with lung congestion as assessed by chest ultrasound in
            diabetics undergoing hemodialysis

Santos, Paulo Roberto; Neto, José Antônio de Lima; Carneiro, Raimundo Aragão Aires; Soares, Antônio Igor Taumaturgo Dias; Oliveira, Wanessa Ribeiro de; Figueiredo, Juliana Oliveira; Filho, Narcélio Menezes Silva; Silva, Thais Oliveira

doi:10.5935/0101-2800.20170073

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…9,14-16 LUS correlated with thoracic BIA which similarly represented lung congestion but was controversially related with total body BIA, an indication of systemic congestion. 16,24,41,43 In the present study, the TLUSS, ECF, and AFO correlated with the accumulated weight gain, and the TLUSS positively correlated with TBW, ICW, LTM, and relLTM, and a trend of correlation with the ECW. It was also found that 69.2% of pre-HD non-overhydration cases defined by total BIA really had moderate pulmonary congestion and 33.3% of nonemild pulmonary congestion still had systemic overhydration, therefore, BIA and LUS, which reflect different over-fluid compartments, are complementary and valuable techniques for dry weight guidance.…”

Section: Dovepresssupporting

confidence: 53%

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients

Trirattanapikul¹,

Kongpetch²,

Lukkanalikitkul³

et al. 2022

IJNRD

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Lung ultrasound (LUS) is used for dry weight guidance by assessment of pulmonary congestion in hemodialysis (HD) patients. The aim of this study was to estimate amounts of accumulated fluid by total LUS scores (TLUSS), which were scarcely reported in HD patients who were normal or had a mild functional abnormality. In addition, the correlations between the LUS score of each area and TLUSS were determined to suggest fewer specific areas valuable to shorten the examination time of LUS. Methods: This cohort study was conducted in adult HD patients who have New York Heart Association Classes I-II. LUS and multifrequency bioimpedance (BIA) were performed at baseline and the individual prescribed dry weight was set. Then each LUS was conducted at 28 areas of bilateral intercostal spaces and calculated as TLUSS weekly for eight weeks in which dry weight was adjusted. The second BIA was also measured at week eight. The difference of pre-HD weight and target weight (weight gain; WG) represented the amount of fluid accumulation. Results: Twenty patients with a mean age of 62.2±14.0 years were enrolled. One hundred and sixty-six LUS were performed in which forty episodes of them were simultaneously measured with BIA. Optimum dry weight adjusted by TLUSS which benefited in mean reductions of blood pressure, and cardiothoracic ratios. WG amounts were significantly correlated with TLUSS (r=0.38), and with extracellular fluid (r=0.35) and overhydration fluid (r=0.39) assessed by BIA. Estimations of mean fluid overload were 2.18 (TLUSS ≤15), 2.72 (TLUSS 16-24), 3.17 and 5.03 (TLUSS ≥39) in liters. The cut-off points of sum scores of 12 specific lung areas represented the none-mild were <8, moderate at 8-16, and severe pulmonary congestions were >16. Conclusion: TLUSS estimated accumulated fluid useful for volume and blood pressure controls. Performance of LUS in 12 specific lung areas may reduce spending time and support routine uses of LUS in clinical practice.

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Section: Dovepresssupporting

confidence: 53%

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients

Trirattanapikul¹,

Kongpetch²,

Lukkanalikitkul³

et al. 2022

IJNRD

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“…These comprised 14 prospective cohort studies, 17 cross‐sectional studies, and two prospective observational studies (Figure 1). The meta‐analysis incorporated 13 studies 6,7,18–28 of the included 33 studies, while the other 20 studies, lacking sufficient numerical data, were included for qualitative analysis as part of the systematic review 9,29–47 …”

Section: Resultsmentioning

confidence: 99%

“…The meta-analysis incorporated 13 studies 6,7,18-28 of the included 33 studies, while the other 20 studies, lacking sufficient numerical data, were included for qualitative analysis as part of the systematic review. 9,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]…”

Section: Study Selectionmentioning

confidence: 99%

The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta‐analysis

Elgenidy,

Amin,

Awad

et al. 2024

Hemodialysis International

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Rationale and ObjectivesDetermining dry weight is crucial for optimizing hemodialysis, influencing efficacy, cardiovascular outcomes, and overall survival. Traditional clinical assessment methods for dry weight, relying on factors such as blood pressure and edema, frequently lack reliability. Lung ultrasound stands out as a promising tool for assessing volume status, given its non‐invasiveness and reproducibility. This study aims to explore the role of Lung ultrasound in evaluating the impact of hemodialysis and ultrafiltration on extravascular lung water, with a specific focus on changes in B‐lines post‐hemodialysis compared to pre‐hemodialysis.Materials and MethodsThe research encompassed searches across PubMed, WOS, and Scopus databases for studies related to lung ultrasound and hemodialysis. A meta‐analysis was then performed to determine the mean differences in various parameters before compared to after, hemodialysis, including the number of B‐lines, indexed end‐inspiratory and end‐expiratory inferior vena cava diameters, inferior vena cava collapsibility index, weight, blood pressure, and serum levels of NT‐pro‐BNP.ResultsOur meta‐analysis, included 33 studies with 2301 hemodialysis patients, revealed a significant decrease in the number of B‐lines post‐hemodialysis (mean difference = 8.30, 95% CI [3.55 to 13.05]). Furthermore, there was a noteworthy reduction in inspiratory and expiratory inferior vena cava diameters post‐hemodialysis (mean difference = 2.32, 95% CI [0.31 to 4.33]; mean difference = 4.05, 95% CI [2.44 to 5.65], respectively). Additionally, a significant positive correlation was observed between B‐lines and the maximum inferior vena cava diameter both pre‐ and post‐hemodialysis (correlation coefficient = 0.39; correlation coefficient = 0.32, respectively).ConclusionThese findings indicate the effectiveness of lung ultrasound in detection of volume overload and assessment of response to ultrafiltration in hemodialysis patients.

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“…In this sense, the article by Santos et al 7 is gladly receive and, along with other published studies, serves as a stimulus for multicenter interventional studies that can definitively support the use of point-of-care pulmonary US in the volume assessment of patients undergoing hemodialysis treatment and thereby contribute to optimizing treatment.…”

mentioning

confidence: 99%

“…In a study published in this issue of JBN, Santos et al 7 evaluated variables associated with pulmonary congestion in 73 prevalent dialysis patients with CKD secondary to diabetes who were undergoing hemodialysis treatment and used B-line count to identify extracellular lung water. In multivariate analysis, the number of B-lines was associated with the IVC collapse index determined by two-dimensional US and with the New York Heart Association (NYHA) score but not with hydration status (measured based on bioimpedance) or the echocardiographic parameters utilized.…”

mentioning

confidence: 99%

Transthoracic pulmonary ultrasonography: looking inside the lungs to better treat the dialysis patient

Bastos

Pazeli²,

Fernandes

2017

Jornal Brasileiro De Nefrologia

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Variables associated with lung congestion as assessed by chest ultrasound in diabetics undergoing hemodialysis

Cited by 7 publications

References 16 publications

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients

The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta‐analysis

Transthoracic pulmonary ultrasonography: looking inside the lungs to better treat the dialysis patient

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