The Agreement between Auscultation and Lung Ultrasound in Hemodialysis Patients: The LUST Study

Torino, Claudia; Gargani, Luna; Sicari, Rosa; Letachowicz, Krzysztof; Ekart, Robert; Fliser, Danilo; Covic, Adrian; Siamopoulos, Kostas C.; Stavroulopoulos, Aristeidis; Massy, Ziad A.; Fiaccadori, Enrico; Caiazza, A.; Bachelet, Thomas; Slotki, Itzchak; Martínez‐Castelao, Alberto; Coudert-Krier, Marie-Jeanne; Rossignol, Patrick; Gueler, Faikah; Hannedouche, Thierry; Panichi, Vincenzo; Wiȩcek, Andrzej; Pontoriero, Giuseppe; Sarafidis, Pantelis A.; Klinger, Marian; Hojs, Radovan; Seiler-Mußler, Sarah; Lizzi, Fabio; Siriopol, Dimitrie; Balafa, Olga; Shavit, Linda; Tripepi, Rocco; Mallamaci, Francesca; Tripepi, Giovanni; Picaño, Eugenio; London, Gérard M.; Zoccali, Carmine

doi:10.2215/cjn.03890416

Cited by 141 publications

(165 citation statements)

References 27 publications

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“…This explains why, as previously reported, volemic measurement made with different techniques can be concordant in full, in part or not at all [8,23,25] .…”

Section: Lus In Hemodialysissupporting

confidence: 75%

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Lung Ultrasound in Hemodialysis: A Card to be Played?

Nicolò¹,

Magnoni

Basile³

2017

Blood Purif

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The end-stage renal disease is characterized by a profound impairment in the regulation of body fluid distribution, and volume assessment in hemodialysis is one of the challenging goals for the nephrologist. To determine a state of euvolemia, different validated techniques have been employed and among them lung ultrasonography (LUS) has recently attracted growing attention on account of its capacity to estimate accurately extra vascular lung water and to detect lung edema even in its early asymptomatic stage, that is, hidden lung congestion.With its noninvasiveness, freedom from radiation, the ease of use, acceptable intra/inter-operator reproducibility and availability of portable ultrasound devices, LUS can be considered one of the most interesting “cards to play” for the volume assessment in patients on hemodialysis.

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“…This explains why, as previously reported, volemic measurement made with different techniques can be concordant in full, in part or not at all [8,23,25] .…”

Section: Lus In Hemodialysissupporting

confidence: 75%

“…At present, a multicenter clinical study in hemodialysis patients with heart disease (LUST trial) is under way in order to answer this clinical question [23] .…”

Section: Lus and Hidden Lung Congestionmentioning

confidence: 99%

Lung Ultrasound in Hemodialysis: A Card to be Played?

Nicolò¹,

Magnoni

Basile³

2017

Blood Purif

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“…This highlights the limitations of clinical examination, which is not reliable enough to exclude a sub-clinical increase in EVLW. As it was recently confirmed, lung auscultation and peripheral edema examination are not reliable for the detection of interstitial lung edema in hemodialysis patients [25]. …”

Section: Discussionmentioning

confidence: 99%

A Simplified Approach to Extravascular Lung Water Assessment Using Point-of-Care Ultrasound in Patients with End-Stage Chronic Renal Failure Undergoing Hemodialysis

Beaubien‐Souligny

Rhéaume

Blondin³

et al. 2017

Blood Purif

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Background: Fluid overload leading to pulmonary congestion is an important issue in patients undergoing hemodialysis. This study aimed to determine if a simplified method of extravascular lung water assessment using ultrasound provided clinically relevant information. Methods: This prospective study recruited 47 patients from a single hemodialysis center. Pulmonary ultrasound was performed before and after 2 hemodialysis sessions in 28 regions on the thorax. The B-line score was defined as the percentage regions where B-lines were present. Results: When B-lines were detected before hemodialysis, a significant relationship was found between fluid removal and the change in B-line score. Patients with a B-line score of ≥21.4% (4th quartile) after the second hemodialysis session were more likely to be hospitalized for pulmonary edema or acute coronary syndrome. Conclusions: A simplified pulmonary assessment using ultrasound provides relevant information about pulmonary congestion in hemodialysis patients and identifies patients at risk of hospitalization for heart-related problems.

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“…This clinical estimation of dry weight is subjective and can often be inaccurate . Different novel techniques such as blood volume online monitoring, bioimpedance spectroscopy, B‐natriuretic peptide levels, inferior vena cava (IVC) measurements and lung ultrasonography (LUS) have been evaluated for dry weight estimation, but these methods are not used routinely in clinical practice …”

Section: Introductionmentioning

confidence: 99%

Comparison between clinical judgment and integrated lung and inferior vena cava ultrasonography for dry weight estimation in hemodialysis patients

Thomas

Mohandas

George

2019

Hemodialysis International

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Introduction: Correct dry weight estimation is very crucial for hemodialysis (HD) patients to maintain euvolemia. Most dialysis centers practice clinical judgment for dry weight estimation, which is subjective and can differ significantly from the actual weight. We designed this study to redefine the clinically estimated dry weight of patients on HD using integrated lung–inferior vena cava (IVC) ultrasonography (USG) and compare the symptoms arising due to volume overload and/or volume depletion before and after modifying the dry weight. Methods: Breathlessness and orthostatic giddiness were scored and documented for 2 weeks while patients were on HD based on clinically estimated dry weight and again for 2 weeks after redefining dry weight using lung–IVC USG. New dry weight was defined as the weight of the patient at which the number of B‐lines was <4 on eight site lung USG and IVC collapsibility index was between 50% and 75%. Findings: After redefining the dry weight, 34 patients (group I) had change in dry weight and 40 (group II) had no change. There was 0.21 ± 1.80 reduction in the score for orthostatic giddiness in group I and 0.03 ± 0.16 in group II (P = 0.147). The score for breathlessness during the 24 hours following dialysis reduced by 0.21 ± 0.41 in group I, but did not change in group II (P = 0.003). Score for breathlessness in the predialysis day reduced by 0.56 ± 0.56 in group I and by 0.05 ± 0.22 in group II (P < 0.001). Discussion: Symptoms related to volume overload and depletion were less when HD prescription was based on lung–IVC USG defined dry weight.

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The Agreement between Auscultation and Lung Ultrasound in Hemodialysis Patients: The LUST Study

Cited by 141 publications

References 27 publications

Lung Ultrasound in Hemodialysis: A Card to be Played?

Lung Ultrasound in Hemodialysis: A Card to be Played?

A Simplified Approach to Extravascular Lung Water Assessment Using Point-of-Care Ultrasound in Patients with End-Stage Chronic Renal Failure Undergoing Hemodialysis

Comparison between clinical judgment and integrated lung and inferior vena cava ultrasonography for dry weight estimation in hemodialysis patients

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