Point-of-Care Echocardiography Improves Assessment of Volume Status in Cirrhosis and Hepatorenal Syndrome.

Point-of-Care Echocardiography Improves Assessment of Volume Status in Cirrhosis and Hepatorenal Syndrome. Am J Med Sci. 2015 Apr 17; Authors: Huggins JT, Doelken P, Walters C, Rockey DC Abstract The management of cirrhotic patients with acute kidney injury is complex and depends in large part on accurate assessment of intravascular volume status. Assessments of intravascular volume status by point-of-care echocardiography often rely solely on inferior vena cava size/variability evaluation; however, this parameter should be intrepretated with an understanding of right ventricular function integrated with stroke volume/flow. Attempts to optimize intra-abdominal hemodynamics favorably are clearly problematic when physical examination findings or rudimentary assessments of central venous pressure or change in central venous pressure are used. Here, we have demonstrated the potential utility of point-of-care echocardiography to optimize the hemodynamic state in decompensated cirrhotics with acute kidney injury. This case is very unique and describes how this technique may have great promise in optimizing intra-abdominal hemodynamics and predict timing of large volume paracentesis in decompensated cirrhotics, which in turn can aid in promoting favorable renal recovery. PMID: 25894072 [PubMed - as supplied by publisher]
Source: The American Journal of the Medical Sciences - Category: Journals (General) Authors: Tags: Am J Med Sci Source Type: research