Dynamic changes and prognosis of pulmonary congestion by lung ultrasound in hemodialysis patients: a systematic review and meta-analysis.

IF 1.8 4区医学 Q2 ACOUSTICS

Medical Ultrasonography Pub Date : 2023-06-26 Epub Date: 2022-10-22 DOI:10.11152/mu-3654

Jianan Zhou, Qi An, Xiukun Hou

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引用次数: 1

Abstract

Aims: Lung ultrasound (LUS) has been rapidly developed to evaluate pulmonary extravascular fluid. A systematic review was conducted to study the dynamic changes of LUS findings of pulmonary congestion before and after hemodialysis and examine the application of LUS for the prognosis of hemodialysis patients.

Material and methods: This study searched online databases for articles on hemodialysis patients that used LUS to evaluate dynamic changes during hemodialysis or prognosis. Articles published in English or Chinese until September 2021 with ≥30 patients were included in this study.

Results: Of the 1329 articles, 14 met the inclusion criteria: 9 reported dynamic changes during dialysis in LUS (438 patients), and 5 reported the prognosis of hemodialysis patients in LUS (1274 patients). As indicated by a further meta-analysis, eight studies found that the combined standardized effect size was -0.74. The all-cause mortality rate of the dialysis patient group with high B-line scores was three times that of the dialysis patient group with low B-line scores. In dialysis patients, no difference was found between the LUS guided treatment and the conventional care in reducing the all-cause mortality (HR=0.92 95%CI: 0.67-1.27) and cardiovascular events (HR=0.98 95%CI: 0.72 -1.34).

Conclusions: LUS can be used to effectively evaluate the volume status of hemodialysis patients in real time. The level of B-line before dialysis is significantly correlated with the poor prognosis. However, compared with the routine nursing group, the treatment of hemodialysis patients with LUS-guided volume management cannot effectively reduce mortality and cardiovascular events.

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血液透析患者肺部超声检测肺充血的动态变化和预后：一项系统综述和荟萃分析。

目的：肺超声（LUS）在评价肺血管外液方面发展迅速。对血液透析前后肺充血LUS表现的动态变化进行了系统综述，并探讨了LUS在血液透析患者预后中的应用。材料和方法：本研究在网上数据库中搜索关于血液透析患者的文章，这些文章使用LUS来评估血液透析过程中的动态变化或预后。本研究包括截至2021年9月以英文或中文发表的≥30名患者的文章。结果：在1329篇文章中，14篇符合纳入标准：9篇报道了LUS透析过程中的动态变化（438名患者），5篇报道了血液透析患者在LUS的预后（1274名患者）。如进一步的荟萃分析所示，八项研究发现，综合标准化效应大小为-0.74。B线评分高的透析患者组的全因死亡率是B线评分低的透析患者的三倍。在透析患者中，LUS指导治疗和常规护理在降低全因死亡率（HR=0.92 95%CI:0.67-12.7）和心血管事件（HR=0.98 95%CI:0.72-1.34）方面没有发现差异。结论：LUS可用于实时有效评估血液透析患者的容量状态。透析前B线水平与不良预后显著相关。然而，与常规护理组相比，LUS引导的容量管理治疗血液透析患者并不能有效降低死亡率和心血管事件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.20

自引率

5.90%

发文量

期刊介绍： The journal aims to promote ultrasound diagnosis by publishing papers in a variety of categories, including editorial letters, original papers, review articles, pictorial essays, technical developments, case reports, letters to the editor or occasional special reports (fundamental, clinical as well as methodological and educational papers). The papers published cover the whole spectrum of the applications of diagnostic medical ultrasonography, including basic science and therapeutic applications. The journal hosts information regarding the society''s activities, scheduling of accredited training courses in ultrasound diagnosis, as well as the agenda of national and international scientific events.