Sergio Velasco Malagón, Estivalis Acosta-Gutiérrez, José Atilio Nuñez-Ramos, Sebastián Salinas, Guillermo Mora Pabón – Heart failure (HF) is a complex entity that increases the risk of adverse outcomes. Point of care ultrasound (POCUS) allows easy lung and systemic venous congestion identification. Using ultrasound to detect sub-clinical congestion at discharge may help predict readmissions and mortality.
Abhilash Koratala, MD; Mohamed Ibrahim, MD; Sirisha Gudlawar, MD – Venous Excess Ultrasound (VExUS) is a valuable bedside tool for nephrologists within a multi-organ point of care ultrasound (POCUS) framework. VExUS can address limitations of conventional physical examination in identifying hemodynamic congestion and monitoring treatment efficacy. A 53-year-old man with heart failure and end-stage kidney disease on hemodialysis presented with elevated liver function tests.
Justin C. Magin; Jacob R. Wrobel; Xinming An; Jacob Acton; Alexander Doyal; Shawn Jia; James C. Krakowski; Jay Schoenherr; Ricardo Serrano; David Flynn; Duncan McLean; Stuart A. Grant – Perioperative fluid administration impacts the rate of complications following surgery. VExUS grading system is a standardized point of care ultrasound (POCUS)-based, comprehensive method to assess volume status. VExUS could serve as a tool to guide fluid management, if validated perioperatively. The primary aim was to assess the success rate of obtaining required windows for VExUS grading , as well as the feasibility within a perioperative setting among noncardiac surgery. Further, this study describes the incidence of perioperative venous congestion and associations with 30-day postoperative complications.
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.
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.
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.
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.