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Fluid overload is associated with adverse outcomes in patients with severe acute kidney injury. It remains unclear if fluid overload is merely a marker of disease severity or if organ congestion is a mediator of complications. Point-of-care ultrasound could be a modality used to assess organ congestion and its clinical implications. The objective of this study is to determine whether ultrasound markers of organ congestion are associated with major adverse kidney events in critically ill patients with severe acute kidney injury.
Background: Fluid overload is associated with adverse outcomes in patients with severe acute kidney injury. It remains unclear if fluid overload is merely a marker of disease severity or if organ congestion is a direct mediator of complications. Point-of-care ultrasound could be a modality used to assess organ congestion and its clinical implications.
Objective: To determine whether ultrasound markers of organ congestions are associated with major adverse kidney events and other adverse clinical outcomes.
Study design: A cohort of critically ill patients with a new onset of severe acute kidney injury will undergo repeated ultrasound assessments to detect the presence of the following markers:
- Portal flow pulsatility on pulse-wave Doppler
- Discontinuous intra-renal venous flow on pulse-wave Doppler
- Abnormal hepatic vein waveform on pulse wave Doppler
- Presence of pulmonary B-line artifacts on 2D lung ultrasound
- Presence of dilated and non-collapsible inferior vena cava on 2D ultrasound
- Presence of systolic right ventricular dysfunction
- Presence of systolic left ventricular dysfunction
Clinical outcomes will be collected for up to 90 days after recruitment.
Perspective: An approach targeting the resolution of organ congestion might improve the prognosis in patients with severe acute kidney injury. Identifying clinically relevant markers of organ congestion is a precursor to the design of future interventional trials investigating personalized fluid balance management.
Acute Kidney Injury
Portal vein flow, Intra-renal flow, Hepatic vein flow, Pulmonary B-lines, Dimensions of the inferior vena cava, Left ventricular function, Right ventricular function
University of Kentucky
Centre hospitalier de l'Université de Montréal (CHUM)
Published on BioPortfolio: 2019-09-24T05:27:28-0400
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