Assessment of fluid status in hemodialysis patients using the lung ultrasound (Master thesis)
Κεσκίνης, Χριστόδουλος/ Kaskinis, Christodoulos
Introduction: The determination of dry weight in hemodialysis patients remains a common problem. The use of lung ultrasound is an emerging method of assessing the hydric status of hemodialysis patients by detecting the presence of fluid in the of the interstitial lung tissue.
Materials and Method: This study included 68 hemodialysis patients from the Dialysis Unit of Papagoergiou General Hospital. The patients underwent lung and Inferior Vena Cava (IVC) ultrasound 30 minutes before and after the end of the dialysis session by a nephrology resident. Patients' dry weight was modified based on daily clinical practice rather than ultrasound findings. The presence of b lines and ultrasound findings of the IVC were evaluated. Six patients were reassessed due to a reduction in their dry weight of 0.5L. While, only 1 patient was evaluated 3 times. In total, 150 lung and inferior vena cava ultrasounds were performed. At the same time, the detection of overhydration was compared between the available chest zone protocols (28.8.6 and 4 zone) of lung ultrasound. Results: The average B line score was 11.53±5.02 before dialysis and it was 5.57 ±3.14 after the session. The average diameter of the IVC was 14.266± 0.846 mm before dialysis and 12.328 ± 0.879 mm after the session. The patients were categorized based on the magnitude of overhydration and the findings were evaluated. After the dialysis session, a statistically significant correlation was found between the b line score and the diameter of the inferior vena cava adjusted for the body surface area. (p=0,009<0,05). It emerged that the 28-zone protocol detected hyperhydration in a much larger percentage of patients before (25%) and after dialysis (16.17%) than the other protocols. Conclusions: A high rate of hyperhydration was detected before the dialysis session (25%). It seems that the 28-zone protocol provides greater precision. While, it is the first study conducted by a nephrology resident highlighting that it is a feasible technique. Intervention studies should be carried out in the future in order to draw more precise conclusions.
Institution and School/Department of submitter: | Δημοκρίτειο Πανεπιστήμιο Θράκης. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής |
Subject classification: | Hemodialysis |
Keywords: | Hemodialysis,Dry weight,Lung ultrasound,Αιμοκάθαρση,Ξηρό βάρος,Υπερηχογράφημα πνευμόνων |
URI: | https://repo.lib.duth.gr/jspui/handle/123456789/18278 http://dx.doi.org/10.26257/heal.duth.17004 |
Appears in Collections: | Π.Μ.Σ. ΜΕΘΟΔΟΛΟΓΙΑ ΤΗΣ ΣΥΓΧΡΟΝΗΣ ΑΝΤΙΜΕΤΩΠΙΣΗΣ ΤΗΣ ΝΕΦΡΙΚΗΣ ΑΝΕΠΑΡΚΕΙΑΣ |
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KeskinisC_2023.pdf | Μεταπτυχιακή εργασία | 2.36 MB | Adobe PDF | View/Open |
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https://repo.lib.duth.gr/jspui/handle/123456789/18278
http://dx.doi.org/10.26257/heal.duth.17004
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