Duplex Assessment Of Renal Perfusion After Fluid Administration In Critically-Ill Patients
DOI:
https://doi.org/10.47750/pnr.2023.14.02.422Abstract
Background: Circulatory shock is a life-threatening medical condition that characterized by a significant reduction of systemic tissue perfusion, resulting in decreased oxygen delivery to the tissues. Doppler ultrasound. Imaging of the kidneys can provide information about secondary damage to the kidneys from chronic poor blood-flow Aim: to evaluate changes in interlobar artery (ILA) resistivity index (RI) (ILA RI), using Doppler techniques, during volume expansion in critically ill patients and, in addition, to compare the performance of these changes with that of changes in systemic hemodynamics for the prediction of subsequent variations in urine output. We hypothesized that dynamic analysis of intrarenal hemodynamic using RIAD following a fluid challenge may help to identify responders to fluids better than systemic hemodynamics. Subjects and Methods: This study was a prospective cohort study conducted on 50 patients admitted to critical care department, Kasr El Aini Hospital. 40 patients were admitted with acute circulatory failure and 10 patients were served as control group. The control group included ICU patients with stable systemic hemodynamic receiving no specific intervention and has no problem to receive IV fluids. On the other hand, the interventional group consisted of patients with acute circulatory failure who required a fluid challenge. Results: This study showed that fluid challenge in critically ill patients with acute circulatory failure was associated with significantly decreased RI as assessed by RIAD. In addition, changes in RI were associated with improvement in MAP without significant correlation. However, these changes were not associated with UOP improvement. Conclusion: • The use of renal Doppler could help to predict the response to fluid challenge in patients with circulatory failure; however, the use of renal Doppler will be of limited value if the sonographer doesn’t have the required experience.
