肺超声评估正常或轻度症状血液透析患者的过度水合作用和血压控制。

IF 2.1 Q2 UROLOGY & NEPHROLOGY
Akeatit Trirattanapikul, Sawinee Kongpetch, Eakalak Lukkanalikitkul, Anucha Ahooja, Patamapon Seesuk, Amod Sharma, Sirirat Anutrakulchai
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引用次数: 0

摘要

简介:肺超声(LUS)用于干重指导评估肺充血在血液透析(HD)患者。本研究的目的是通过总LUS评分(TLUSS)来估计积液量,这在正常或轻度功能异常的HD患者中几乎没有报道。此外,测定各区域LUS评分与TLUSS的相关性,提示减少有价值的特定区域,以缩短LUS的检查时间。方法:该队列研究在纽约心脏协会分级为I-II级的成年HD患者中进行。在基线时进行LUS和多频生物阻抗(BIA),并设定个体规定的干重。然后在双侧肋间隙的28个区域进行每个LUS,并计算为每周TLUSS,为期8周,其中干重调整。第二BIA也在第8周测量。hd前体重与目标体重的差异(增重;WG)表示液体积聚量。结果:20例患者入组,平均年龄62.2±14.0岁。共进行了166例LUS,其中40例同时进行BIA测量。通过TLUSS调整的最佳干重有利于血压和心肺比值的平均降低。WG量与TLUSS (r=0.38)、BIA评估细胞外液(r=0.35)和过度水化液(r=0.39)显著相关。平均流体过载估计分别为2.18 (TLUSS≤15)、2.72 (TLUSS 16-24)、3.17 (TLUSS 25-33)、3.65 (TLUSS 34-38)和5.03 (TLUSS≥39)升。代表非轻症的12个特定肺区总评分的分界点为16。结论:TLUSS估计累积的液体有助于控制体积和血压。LUS在12个特定肺区域的表现可以减少花费时间,并支持LUS在临床实践中的常规使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients.

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients.

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients.

Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients.

Introduction: Lung ultrasound (LUS) is used for dry weight guidance by assessment of pulmonary congestion in hemodialysis (HD) patients. The aim of this study was to estimate amounts of accumulated fluid by total LUS scores (TLUSS), which were scarcely reported in HD patients who were normal or had a mild functional abnormality. In addition, the correlations between the LUS score of each area and TLUSS were determined to suggest fewer specific areas valuable to shorten the examination time of LUS.

Methods: This cohort study was conducted in adult HD patients who have New York Heart Association Classes I-II. LUS and multifrequency bioimpedance (BIA) were performed at baseline and the individual prescribed dry weight was set. Then each LUS was conducted at 28 areas of bilateral intercostal spaces and calculated as TLUSS weekly for eight weeks in which dry weight was adjusted. The second BIA was also measured at week eight. The difference of pre-HD weight and target weight (weight gain; WG) represented the amount of fluid accumulation.

Results: Twenty patients with a mean age of 62.2±14.0 years were enrolled. One hundred and sixty-six LUS were performed in which forty episodes of them were simultaneously measured with BIA. Optimum dry weight adjusted by TLUSS which benefited in mean reductions of blood pressure, and cardiothoracic ratios. WG amounts were significantly correlated with TLUSS (r=0.38), and with extracellular fluid (r=0.35) and overhydration fluid (r=0.39) assessed by BIA. Estimations of mean fluid overload were 2.18 (TLUSS ≤15), 2.72 (TLUSS 16-24), 3.17 (TLUSS 25-33), 3.65 (TLUSS 34-38) and 5.03 (TLUSS ≥39) in liters. The cut-off points of sum scores of 12 specific lung areas represented the none-mild were <8, moderate at 8-16, and severe pulmonary congestions were >16.

Conclusion: TLUSS estimated accumulated fluid useful for volume and blood pressure controls. Performance of LUS in 12 specific lung areas may reduce spending time and support routine uses of LUS in clinical practice.

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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
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