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Utility of Nephrologist-Performed Point of Care Ultrasonography in the Evaluation of Hyponatremia.

ABSTRACT: 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. Herein, we present a case of a 35-year-old woman where discrepant clinical findings led to confusion in the accurate assessment of volume status but addition of point of care ultrasonography helped to guide the therapy.

SUBMITTER: Saqib M

PROVIDER: S-EPMC9994294 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Utility of Nephrologist-Performed Point of Care Ultrasonography in the Evaluation of Hyponatremia.

Saqib Mahmud M Capelli Gregory G Koratala Abhilash A

POCUS journal 20220201 Kidney

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. Herein, we present a case of a 35-year-old woman where discrepant clinical findings led to confusion in the accurate assessment of volume status but addition of point of care ultr ...[more]

PMID: 36896103

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Project description:BACKGROUND:Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing countries is not straightforward. METHODS:Our objective was to investigate current practice and education regarding POCUS among Brazilian intensivists. A national survey was administered to Brazilian intensivists using an electronic questionnaire. Questions were selected by the Delphi method and assessed topics included organizational issues, POCUS technique and training patterns, machine availability, and main applications of POCUS in daily practice. RESULTS:Of 1533 intensivists who received the questionnaire, 322 responded from all of Brazil's regions. Two hundred and five (63.8%) reported having access to an ultrasound machine dedicated to the intensive care unit (ICU); however, this was more likely in university hospitals than in non-university hospitals (80.6 vs. 59.6%; risk ratio [RR] = 1.35 [1.16-1.58], p = 0.002). The main applications of POCUS were ultrasound-guided central vein catheterization (49.4%) and bedside echocardiographic assessment (33.9%). Two hundred and fifty-eight (80.0%) reported having at least one POCUS-trained intensivist in their staff (trained units). Trained units were more likely to perform routine ultrasound-guided jugular vein catheterization than non-trained units (38.6 vs. 16.4%; RR = 2.35 [1.31-4.23], p = 0.001). The proportion of POCUS-trained intensivists and availability of a dedicated ultrasound machine were both independently associated with performing ultrasound-guided jugular vein catheterization (RR = 1.91 [1.32-2.77], p = 0.001) and (RR = 2.20 [1.26-3.29], p = 0.005), respectively. CONCLUSIONS:A significant proportion of Brazilian ICUs had at least one intensivist with POCUS capability in their staff. Although ultrasound-guided central vein catheterization constitutes the main application of POCUS, adherence to guideline recommendations is still suboptimal.

Dataset Information

Utility of Nephrologist-Performed Point of Care Ultrasonography in the Evaluation of Hyponatremia.

Publications

Utility of Nephrologist-Performed Point of Care Ultrasonography in the Evaluation of Hyponatremia.

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