Association between B-lines detected during lung ultrasound and various factors in hemodialysis patients

Kuzuhara, S; Otsubo, Shigeru; Kajimoto, Katsuya; Akiba, Takashi; Nitta, Kosaku

doi:10.1186/s41100-017-0101-3

Cited by 6 publications

(14 citation statements)

References 37 publications

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“…The lateral zone was positioned from the anterior axillary line to the posterior axillary line and was also divided into the upper and lower halves. The investigator attempted to detect comet tail artifacts fanning out from the lung-wall interface and spreading to the edge of the screen, which were previously named B-lines [5,8]. The total number of B-lines was estimated.…”

Section: Methodsmentioning

confidence: 99%

“…The number of post-dialysis Blines is correlated with the residual weight assessed using bioimpedance, suggesting a role for ultrasound in the management of hemodialysis patients [7]. Lung ultrasound is also reportedly useful for the accurate evaluation of dry weight and fluid status in hemodialysis patients [2,8,9]. The number of B-lines observed using lung ultrasound represents the severity of pulmonary congestion [10].…”

Section: Introductionmentioning

confidence: 99%

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Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

et al. 2019

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Background: Volume overload in hemodialysis patients is an independent risk factor for cardiovascular eventrelated mortality. The number of B-lines observed using lung ultrasound is correlated with the severity of pulmonary congestion. The aim of this study was to evaluate the association between the number of B-lines and mortality among hemodialysis patients. Methods: A total of 61 patients receiving maintenance hemodialysis were enrolled in this study. Clinical data including age, sex, duration of hemodialysis therapy, presence of diabetes mellitus and/or hypertension and/or dyslipidemia complications, the results of biological examinations, and outcome were collected from the patients' clinical records. We performed echographic examinations at three time points (just after the start, during the middle, and just before the end of hemodialysis therapy). A univariate Cox proportional hazard model was used to identify predictors of the overall outcomes. Furthermore, we divided patients into two groups according to the median number of the B-lines at the end of dialysis and compared the mortality between the two groups. Results: The mean follow-up period was 507 ± 385 days. During the follow-up period, 24 deaths were recorded. Predictive variables for mortality included age; serum level of albumin, creatinine, and N-terminal pro-brain natriuretic peptide; and body weight (P < 0.001, P < 0.0001, P < 0.001, P = 0.014, and P = 0.019, respectively). The number of B-lines at the start, middle, and end of dialysis therapy was correlated with mortality (hazard ratio (95% confidence interval) 1.20 (1.09-1.32), P = 0.0002; 1.17 (1.07-1.28), P = 0.0008; and 1.23 (1.12-1.37), P = 0.0001; respectively). The mortality was statistically higher in the group with 5 or more B-lines than in the group with less than 5 B-lines (P = 0.013). Conclusions: The number of B-lines at the start, middle, and end of hemodialysis therapy may be correlated with mortality among hemodialysis patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

et al. 2019

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“…B-lines within physiological range may be present. We have previously reported that B-lines are associated with low serum level of albumin and low body weight [6]. So, optimal number of B-lines may be different among hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

“…The investigators attempted to detect comet tail artifacts fanning out from the lung-wall interface and spreading to the edge of the screen, which were previously named as B-lines ( Fig. 1) [5,6]. The total number of B-lines was estimated.…”

Section: Methodsmentioning

confidence: 99%

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Associations between fluid removal and number of B-lines, peak early mitral inflow wave velocity, and inferior vena cava dimensions in hemodialysis patients

et al. 2017

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Background: The inferior vena cava (IVC) dimensions represent the right ventricular preload, whereas the peak early mitral inflow wave velocity (peak E-velocity) represents the left ventricular preload. On the other hand, B-lines represent extravascular lung water. The aim of this study was to evaluate possible acute changes in the IVC dimensions, peak E-velocity, and number of B-lines during hemodialysis therapy. Methods: A total of 55 consecutive patients receiving maintenance hemodialysis were enrolled in this study. We performed echo-graphic examinations at three time points (just after the start, during the middle, and just before the end of the hemodialysis therapy). We then investigated the changes in the IVC dimensions, peak E-velocity, and number of B-lines. Results: The peak E-velocity decreased from 80 ± 26 cm/s at the start of the therapy to 58 ± 22 cm/s during the middle and 51 ± 21 cm/s at the end of the therapy. The IVC dimensions also decreased from 15 ± 4 mm at the start of the therapy to 12 ± 3 mm during the middle and 11 ± 3 mm at the end of the therapy. The number of B-lines also decreased from 12 ± 5 at the start of the therapy to 9 ± 4 during the middle and 5 ± 3 at the end of the therapy. The changes in the peak E-velocity and IVC dimensions were significantly greater during the first half of the dialysis period than during the second half of the dialysis period (P < 0.0001 and P < 0.0001, respectively). On the other hand, the changes in the number of B-lines during these periods were significantly smaller during the first half of the dialysis period than during the second half of the dialysis period (P = 0.0016). Conclusions: We showed that the peak E-velocity and the IVC dimensions were reduced mainly during the first half of the dialysis period, while the number of B-lines showed a significant decrease mainly during the last half of the dialysis period. Even if the IVC dimensions are reduced sufficiently, caution is needed as lung congestion may still exist.

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The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta‐analysis

Elgenidy,

Amin,

Awad

et al. 2024

Hemodialysis International

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Rationale and ObjectivesDetermining dry weight is crucial for optimizing hemodialysis, influencing efficacy, cardiovascular outcomes, and overall survival. Traditional clinical assessment methods for dry weight, relying on factors such as blood pressure and edema, frequently lack reliability. Lung ultrasound stands out as a promising tool for assessing volume status, given its non‐invasiveness and reproducibility. This study aims to explore the role of Lung ultrasound in evaluating the impact of hemodialysis and ultrafiltration on extravascular lung water, with a specific focus on changes in B‐lines post‐hemodialysis compared to pre‐hemodialysis.Materials and MethodsThe research encompassed searches across PubMed, WOS, and Scopus databases for studies related to lung ultrasound and hemodialysis. A meta‐analysis was then performed to determine the mean differences in various parameters before compared to after, hemodialysis, including the number of B‐lines, indexed end‐inspiratory and end‐expiratory inferior vena cava diameters, inferior vena cava collapsibility index, weight, blood pressure, and serum levels of NT‐pro‐BNP.ResultsOur meta‐analysis, included 33 studies with 2301 hemodialysis patients, revealed a significant decrease in the number of B‐lines post‐hemodialysis (mean difference = 8.30, 95% CI [3.55 to 13.05]). Furthermore, there was a noteworthy reduction in inspiratory and expiratory inferior vena cava diameters post‐hemodialysis (mean difference = 2.32, 95% CI [0.31 to 4.33]; mean difference = 4.05, 95% CI [2.44 to 5.65], respectively). Additionally, a significant positive correlation was observed between B‐lines and the maximum inferior vena cava diameter both pre‐ and post‐hemodialysis (correlation coefficient = 0.39; correlation coefficient = 0.32, respectively).ConclusionThese findings indicate the effectiveness of lung ultrasound in detection of volume overload and assessment of response to ultrafiltration in hemodialysis patients.

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Association between B-lines detected during lung ultrasound and various factors in hemodialysis patients

Cited by 6 publications

References 37 publications

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

Associations between pulmonary congestion on chest ultrasound and survival in hemodialysis patients

Associations between fluid removal and number of B-lines, peak early mitral inflow wave velocity, and inferior vena cava dimensions in hemodialysis patients

The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta‐analysis

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