Transesophageal Doppler Measurement of Renal Arterial Blood Flow Velocities and Indices in Children

Abstract

This study confirms the feasibility of obtaining 2-dimensional images of kidney parenchyma and Doppler-derived measurements using TEE in children. Angle-independent TEE Doppler-derived indices show significant concordance with those derived by TAU. Further studies are required to assess whether this correlation holds true in the presence of renal pathology. This technique has the potential to help modulate intraoperative interventions based on their impact on renal variables and may prove helpful in the perioperative period for children at risk of acute kidney injury.

Renal Duplex Sonographic Evaluation of Type 2 Diabetic Patients

“…Moreover, advanced arteriosclerosis in intrarenal arteries at an advanced stage of diabetic nephropathy may contribute to the increase in the RI 48 . Therefore, renal hypertrophy and the increase in the RI could represent two different phases: renal enlargement is a prealbuminuric reversible step of renal involvement in diabetes mellitus, whereas the RI increase indicates the progression of disease with renal scarring, which precedes the appearance of albuminuria 49 – 52 …”

“…48 Therefore, renal hypertrophy and the increase in the RI could represent two different phases: renal enlargement is a prealbuminuric reversible step of renal involvement in diabetes mellitus, whereas the RI increase indicates the progression of disease with renal scarring, which precedes the appearance of albuminuria. [49][50][51][52] There is evidence that suggests that the risk of developing diabetic nephropathy begins when urinary albumin excretion values are still in the normoalbuminuric range 53,54 ; however, excluding biopsy, no humoral or imaging parameter exists that can reveal earlier stages of nephropathy. Diabetic nephropathy is a progressive condition that often heralds increasing creatinine as the final manifestation, and as it evolves, the risk of cardiovascular complications increases.…”

Transgastric Abdominal Ultrasonography in Anesthesia and Critical Care: Review and Proposed Approach

“…The use of TGAUS to image the right kidney using a TG short-axis view has been reported in adults and in children. 85,86 In our experience, it is difficult to identify the right kidney given its location further from the stomach. Once the 2D examination is complete, interrogation of the arterial and venous circulation can be done using Doppler at a Nyquist limit of 10 cm/s.…”

“…Oligoanuria: renal arterial hypoperfusion or elevate renal resistance index, 77,[82][83][84][85][86][87][88][89][90] renal venous congestion, 78,83 left hydronephrosis and renal artery air embolization, 77 and differentiating acute versus chronic renal failure 14 Pancreatic view 9 and subpancreatic splenic vessel view 10 Splenic venous Doppler monitoring right ventricular dysfunction associated with venous congestion 14,[75][76][77] and evaluation of response to medical treatment 27,78 Abbreviations: ECMO, extracorporeal membrane oxygenation; IVC, inferior vena cava; PFO, patent foramen ovale; SMA, superior mesenteric artery; TGAUS, transgastric abdominal ultrasonography.…”

A Simple Approach for Sample Size Calculation for Comparing Two Concordance Correlation Coefficients Estimated on the Same Subjects

“…Application of the CCC has recently gained popularity (Zar, 1996;Dixon et al, 2009;Barchard, 2012). The CCC has been used as a measure of reproducibility/agreement in more than 200 medical publications since the beginning of the decade in areas such as respiratory illness (Dixon et al, 2009, Kocks et al, 2010, sleep (Khawaja et al, 2010), pediatrics (Liottol et al, 2010), pediatric heart transplantation (Camarda et al, 2013), brain research (Wang et al, 2012), neurology (MacDougall et al, 2009), asthma and occupational allergic disease (King et al, 2013), renal pathologies (Zabala et al, 2012), and radiology (Mazaheri et al, 2009).…”