Assistance Publique des Hôpitaux de Paris, Service d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Centre Hospitalier Universitaire de Bicêtre, Université Paris XI, Le Kremlin-Bicêtre Cedex, France.
Shock. 2012 Apr;37(4):360-5. doi: 10.1097/SHK.0b013e3182467156.
Despite our increasing ability to support vital organs and resuscitate patients, the morbidity and mortality of acute kidney injury (AKI) remain high in the intensive care unit (ICU). The ability to predict the occurrence of AKI is crucial for the development of preventive strategies. Early diagnosis of AKI requires markers that are sensitive and easily applicable in clinical practice. The use of Doppler ultrasonography to assess renal perfusion is increasing in many kidney diseases and in the ICU. The Doppler-based renal resistive index, which is a simple, rapid, noninvasive, and repeatable marker, could be a promising tool to prematurely detect the patients most at risk of developing AKI in the ICU and to distinguish transient from persistent AKI. Moreover, the resistive index could also be useful to adjust preventive or therapeutic modalities for the kidney perfusion at the bedside. The recent progress in ultrasound with contrast-enhanced ultrasound gives the opportunity to assess not only the kidney macrocirculation but also the kidney microcirculation in the ICU.
尽管我们越来越有能力支持重要器官并使患者复苏，但重症监护病房（ICU）中急性肾损伤（AKI）的发病率和死亡率仍然很高。预测 AKI 发生的能力对于制定预防策略至关重要。AKI 的早期诊断需要在临床实践中既敏感又易于应用的标志物。在许多肾脏疾病和 ICU 中，使用多普勒超声评估肾灌注的方法正在增加。基于多普勒的肾阻力指数是一种简单、快速、无创且可重复的标志物，它可能是一种很有前途的工具，可以提前检测出 ICU 中最有可能发生 AKI 的患者，并区分一过性 AKI 和持续性 AKI。此外，阻力指数也可用于调整床边的肾脏灌注的预防或治疗方式。最近，超声造影技术的进展使得不仅可以评估肾脏的大循环，还可以评估 ICU 中的肾脏微循环。
