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Ultrasound Markers of Organ Congestion in Severe Acute Kidney Injury

2019-09-24 05:27:28 | BioPortfolio

Summary

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.

Description

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.

Study Design

Conditions

Acute Kidney Injury

Intervention

Portal vein flow, Intra-renal flow, Hepatic vein flow, Pulmonary B-lines, Dimensions of the inferior vena cava, Left ventricular function, Right ventricular function

Location

University of Kentucky
Lexington
Kentucky
United States
40506

Status

Recruiting

Source

Centre hospitalier de l'Université de Montréal (CHUM)

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-09-24T05:27:28-0400

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Medical and Biotech [MESH] Definitions

Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.

A short thick vein formed by union of the superior mesenteric vein and the splenic vein.

Anastomosis of splenic vein to renal vein to relieve portal hypertension.

Veins which return blood from the intestines; the inferior mesenteric vein empties into the splenic vein, the superior mesenteric vein joins the splenic vein to form the portal vein.

The amount of PLASMA that perfuses the KIDNEYS per unit time, approximately 10% greater than effective renal plasma flow (RENAL PLASMA FLOW, EFFECTIVE). It should be differentiated from the RENAL BLOOD FLOW; (RBF), which refers to the total volume of BLOOD flowing through the renal vasculature, while the renal plasma flow refers to the rate of plasma flow (RPF).

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