This
new study in CJASN looked at >1000 patients pre and post HD via lung
ultrasound simultaneous to standardized lung exams ( crackles ) and peripheral
edema. What the investigators found was
that the lung congestion by crackles, edema or a combination was inferior to
ultrasound B lines in various analysis. Using
the knowledge of B lines might guide us in better managing volume status in our
ESRD patients.
In
the editorial with it in CJASN, Dr. Rich Sherman writes “I believe that lung US will prove to be
of value in improving the care of patients on dialysis . From a practical
standpoint, I hope that this technique can provide us with at least one simple
benefit. If a routine lung US on the previous Friday before dialysis might make
these events less likely, then sign me up!”
I concur with Dr
Sherman! I think Nephrologists should get familiar with the science and
technology and embrace this change to help their patients. Dialysis units (
large and small) should consider carrying US machines to help guide volume exam
and make clinical decisions. It will decrease hospitalizations, less radiation
exposure( X rays) and hopefully less ER visits.
Image courtesy: coreem.net
This is really very interesting and innovative both. It will surely going to help in many ways. It looks very impressive. Thanks for sharing this write-up.
ReplyDeleteRefurbished ultrasound machine by Redstonehealthcare.com