Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study

Ehlayel, Abdulla M.; Okunowo, Oluwatimilehin; Dutt, Mohini; Howarth, Kathryn; Zemel, Babette S.; Poznick, Laura; Morgan, Xenia; Copelovitch, Lawrence; Back, Susan J.; Otero, Hansel J.; Hartung, Erum A.

doi:10.1186/s12882-022-03012-1

Cited by 2 publications

(2 citation statements)

References 46 publications

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“…However these are difficult to quantify or follow-up over time [52]. Scoring systems have been developed, but their clinical usefulness and reliability remain unclear [53,54]. Many clinical teams will use body weight and calculated fluid balance to track fluid overload development [55].…”

Section: Evaluation Of Fluid Overloadmentioning

confidence: 99%

“…Measuring thoracic or total body bioimpedance enables the calculation of body fluid content. These noninvasive measurements are easy to apply at the bedside and may reflect the amount of edema in children, although the clinical value remains to be determined [54,70]. However it requires specific monitoring devices only rarely used in PICUs.…”

Section: Evaluation Of Fluid Overloadmentioning

confidence: 99%

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Evaluating fluid overload in critically ill children

Bem,

Lemson

2024

Current Opinion in Pediatrics

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Purpose of review To review the evaluation and management of fluid overload in critically ill children. Recent findings Emerging evidence associates fluid overload, i.e. having a positive cumulative fluid balance, with adverse outcome in critically ill children. This is most likely the result of impaired organ function due to increased extravascular water content. The combination of a number of parameters, including physical, laboratory and radiographic markers, may aid the clinician in monitoring and quantifying fluid status, but all have important limitations, in particular to discriminate between intra- and extravascular water volume. Current guidelines advocate a restrictive fluid management, initiated early during the disease course, but are hampered by the lack of high quality evidence. Summary Recent advances in early evaluation of fluid status and (tailored) restrictive fluid management in critically ill children may decrease complications of fluid overload, potentially improving outcome. Further clinical trials are necessary to provide the clinician with solid recommendations.

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Section: Evaluation Of Fluid Overloadmentioning

confidence: 99%

Section: Evaluation Of Fluid Overloadmentioning

confidence: 99%

Evaluating fluid overload in critically ill children

Bem,

Lemson

2024

Current Opinion in Pediatrics

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Assessment of volume status of pediatric hemodialysis patients

Fadel,

Salah,

Mawla

et al. 2024

Pediatr Nephrol

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Background Accurate volume status assessment and dry weight achievement are the most challenging goals for a nephrologist. We aimed to evaluate the role of ultrasonographic parameters including lung ultrasound and inferior vena cava (IVC) measurements as practical methods of volume status assessment in children on hemodialysis by comparing them with established techniques, such as clinical evaluation and bioimpedance spectroscopy. Methods A prospective cross-sectional study compared pre- and post-dialysis volume status using bioimpedance spectroscopy (BIS) parameters and clinical data with ultrasonographic lung B-lines and IVC parameters in children on regular hemodialysis. Results A total 60 children (mean age 9.4 ± 2.8 years) were enrolled. Twenty patients (33.3%) were clinically overloaded to varying degrees (17 patients had mild to moderate signs of fluid overload and 3 patients had moderate to severe signs of fluid overload). All other patients (66.7%) were clinically euvolemic. Sonographic parameters were significantly lower post-dialysis than pre-dialysis, including lung B-line count and IVC diameter. IVC collapsibility index mean was significantly higher post-dialysis than pre-dialysis. There was a significant correlation between the lung B-line count, IVC parameters, and BIS-measured overhydration both before and after hemodialysis. Nine patients had ≥ 8 B-lines post-dialysis, only three of them were hypertensive. Conclusions Clinical criteria alone are not specific for determining accurate fluid status in pediatric hemodialysis patients. Lung B-line score, IVC parameters, and BIS may be complementary to each other and to clinical data. Lung B-lines outperform IVC measurements and BIS in subclinical volume overload detection in pediatric hemodialysis patients. Graphical abstract

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Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study

Cited by 2 publications

References 46 publications

Evaluating fluid overload in critically ill children

Evaluating fluid overload in critically ill children

Assessment of volume status of pediatric hemodialysis patients

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