Development of skills to utilize point-of-care ultrasonography in nephrology practice

Nunes, Aida Aguilar; Júnior, José Muniz Pazeli; Rodrigues, Anderson Tavares; Vieira, Ana Luisa Silveira; Ezequiel, Oscarina da Silva; Colugnati, Fernando Antônio Basile; Bastos, Marcus Gomes

doi:10.5935/0101-2800.20160030

Cited by 9 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent publications suggest that groups of resident physicians acquire skills for the generation and interpretation of US images after short training (3 to 16 hours) at POCUS, structured with theoretical classes and practical sessions. [12][13][14] So far, the number of US examinations required to enable the nephrologist to perform the POCUS in nephrology has not been established, but, as with the acquisition of other medical skills, the learning curve is directly related to the number of USG performed and the frequency of US use.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasonography in nephrology: a cross-sectional national survey among Brazilian nephrologists

Bastos

Vieira²,

Nascimento

et al. 2021

Braz. J. Nephrol.

View full text Add to dashboard Cite

Introduction: Point-of-care ultrasonography (US) (POCUS) has been used in several specialties, particularly in medical emergency. Despite the confirmation of its numerous benefits, the use of POCUS is still timid in nephrology. In the present study, we aim to investigate the use of POCUS by Brazilian nephrologists. Methods: A survey carried out among the members of the Brazilian Society of Nephrology, through institutional e-mail, using the SurveyMonkey platform. We included 12 self-administered questions, which answers were given anonymously. Results: It was evident that the majority (64%) of the participants did not have the opportunity to practice US during their nephrological training in their residency, specialization, or even in internships; those with experience with US use the method mainly for implanting central vascular accesses (68%), performing a renal biopsy (58%) and evaluating renal morphology (50%); and the main barriers for nephrologists who do not yet use US are the high price of US machines (26%) and the lack of time to learn about US (23%). Also, POCUS use for examinations of other organs, such as the lung (31%) and heart (18%), which are fundamental in the cardiovascular and volume assessment of patients with kidney diseases, is even more limited. However, 95% of the participants expressed an interest in learning POCUS for use in their medical practice. Conclusion: Most of the Brazilian nephrologists interviewed were not trained in US; however, almost all of the research participants expressed an interest in learning to use POCUS in nephrological practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasonography in nephrology: a cross-sectional national survey among Brazilian nephrologists

Bastos

Vieira²,

Nascimento

et al. 2021

Braz. J. Nephrol.

View full text Add to dashboard Cite

show abstract

“…The ultrasonographic examinations were performed using a portable ultrasound device (Terason t3000CV; Terason, Burlington, MA, USA) with a high frequency linear transducer (6)(7)(8)(9)(10)(11)(12).…”

Section: Study Protocolmentioning

confidence: 99%

Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients

et al. 2022

View full text Add to dashboard Cite

Background Point of care ultrasound (PoCUS) is a useful tool for the early diagnosis of thrombosis related to the central venous catheter for dialysis (TR-CVCd). However, the application of PoCUS is still not common as a bedside imaging examination and TR-CVCd remains often underdiagnosed in the routine practice. The aim of this study was to investigate if a compression technique for the diagnosis of TR-CVCd blindly performed by PoCUS experts and medical students is accurate when compared to a Doppler study. Methods Two medical students without prior knowledge in PoCUS received a short theoretical–practical training to evaluate TR-CVCd of the internal jugular vein by means of the ultrasound compression technique. After the training phase, patients with central venous catheter for dialysis (CVCd) were evaluated by the students in a private hemodialysis clinic. The results were compared to those obtained on the same population by doctors with solid experience in PoCUS, using both the compression technique and the color Doppler. Results Eighty-one patients were eligible for the study and the prevalence of TR-CVCd diagnosed by Doppler was 28.4%. The compression technique performed by the students and by experts presented, respectively, a sensitivity of 59.2% (CI 51.6–66.8) vs 100% and a specificity of 89.6% (CI 84.9–94.3) vs 94.8% (CI 91.4–98.2). Conclusion The compression technique in the hands of PoCUS experts demonstrated high accuracy in the diagnosis of TR-CVCd and should represent a standard in the routine examination of dialytic patients. The training of PoCUS inexperienced students for the diagnosis of TR-CVCd is feasible but did not lead to a sufficient level of sensitivity.

show abstract

“…When tested in a group of residents, the evaluations showed the development of skills in obtaining images and performing nephrological procedures. 8 …”

Section: Introductionmentioning

confidence: 99%

Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice

2021

Self Cite

View full text Add to dashboard Cite

Point-of-Care Ultrasound (POCUS) has been gaining momentum as an extension to physical examination in several specialties. In nephrology, POCUS has generally been used in a restricted way in urinary tract evaluation. We report the case of a patient with nephrotic syndrome secondary to amyloidosis, previously diagnosed by renal biopsy, who was oligosymptomatic when seen the an outpatient clinic, where the POCUS, focused on the heart, lung and abdomen, revealed anasarca, pulmonary congestion and cardiac changes suggestive of cardiac amyloidosis. After evaluation by the cardiology and hematology services, the diagnosis of AL amyloidosis with cardiac involvement was confirmed. This case emphasizes the importance of extending the physical examination using POCUS, which, ideally, should not be restricted to the urinary tract.

show abstract

Development of skills to utilize point-of-care ultrasonography in nephrology practice

Abstract: A 16-hour nephrology POCUS training course that was not limited to topics involving the urinary tract enabled the development of skills to obtain images and perform Nephrology procedures. The program developed can be used as a model for learning POCUS in Nephrology.

Cited by 9 publications

References 0 publications

Point-of-care ultrasonography in nephrology: a cross-sectional national survey among Brazilian nephrologists

Point-of-care ultrasonography in nephrology: a cross-sectional national survey among Brazilian nephrologists

Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients

Conventional physical examination extended by bedside ultrasound: a new paradigm in nephrological practice

Contact Info

Product

Resources

About