Miguel Romano, MD; Eduardo Viana, MS; José Diogo Martins, MD; Rogério Corga da Silva, MD – Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection with a high mortality rate. Septic shock is a subset of sepsis with manifest circulatory dysfunction (use of vasopressors and persistent elevation of lactic acid) . As stated in literature, in addition to the use of empiric antibiotics and control of the infectious focus, intravenous fluid therapy is an essential intervention to promote hemodynamic stabilization. However, the literature also describes harmful outcomes related to fluid overload.
Article Tags: VExUS
Utility of Nephrologist-Performed Point of Care Ultrasonography in the Evaluation of Hyponatremia
Mahmud Saqib, MD; Gregory Capelli, DO; Abhilash Koratala, MD – Point of care ultrasonography can be a valuable adjunct to conventional physical examination in patients with hyponatremia that aids in clinical decision making. It can address the shortcomings of traditional volume status assessment such as the inherent low sensitivity of ‘classic’ signs such as lower extremity edema.
Point of Care Ultrasonography to Monitor Decongestive Therapy in Heart Failure: Seeing is Believing
Abhilash Koratala, MD – Point of care ultrasonography (POCUS) is a non-invasive bedside diagnostic tool that aids in clinical decision-making process. In addition, it allows to monitor the efficacy of therapeutic interventions in real time. As such, nephrologists can enhance patient care by adopting this skill, especially in those with simultaneous cardiac dysfunction and difficult to manage fluid status.
Evaluation of Venous Congestion Using Beside Ultrasonography by the Nephrology Consultant: The VExUS Nexus
Abhilash Koratala, MD – In patients with heart failure and cardiorenal syndrome, lingering congestion is associated with worse outcomes. As such, titrating diuretic or ultrafiltration therapy based on objective assessment of volume status plays a crucial role in the management of these patients. Conventional physical examination findings and parameters such as daily weight measurement are not always reliable in this setting. Recently, point of care ultrasonography (POCUS) has emerged as an attractive enhancement to bedside clinical examination in assessing fluid volume status.