Division of Nephrology, Centre Hospitalier de l'Université de Montréal.
Department of Anesthesiology and Intensive Care, Montreal Heart Institute.
Curr Opin Nephrol Hypertens. 2018 Nov;27(6):487-496. doi: 10.1097/MNH.0000000000000453.
Following the miniaturization of ultrasound devices, point-of-care ultrasound (POCUS) has been proposed as a tool to enhance the value of physical examination in various clinical settings. The objective of this review is to describe the potential applications of POCUS in end-stage renal disease patients (ESRD).
With basic training, the clinician can perform pulmonary, vascular, cardiac, and abdominal POCUS at the bedside of ESRD patients. Pulmonary ultrasound can be used to quantify pulmonary congestion and for the differential diagnosis of dyspnea. Ultrasound of the inferior vena cava combined with simple cardiac ultrasound can be used to promptly investigate the mechanism of hemodynamic instability. Vascular ultrasound can be used for troubleshooting of arteriovenous fistula problems and for catheter installation. Multiple potential applications of POCUS in the ESRD population are reviewed, including areas of future research.
Acquiring basic skills in POCUS may improve patient care through the rapid identification of threats, improved diagnostic abilities for common symptoms, and safer procedures. The adoption of POCUS in undergraduate, internal medicine and nephrology training curriculums will likely lead to a gradual introduction of this technology in the care of ESRD patients.
随着超声设备的小型化，床边即时超声（POCUS）被提议作为一种在各种临床环境中增强体格检查价值的工具。本综述的目的是描述 POCUS 在终末期肾病（ESRD）患者中的潜在应用。
经过基础培训，临床医生可以在 ESRD 患者床边进行肺部、血管、心脏和腹部 POCUS。肺部超声可用于量化肺充血并进行呼吸困难的鉴别诊断。下腔静脉超声结合简单的心脏超声可用于快速调查血流动力学不稳定的机制。血管超声可用于解决动静脉瘘问题和导管安装问题。回顾了 POCUS 在 ESRD 人群中的多种潜在应用，包括未来研究领域。
通过快速识别威胁、提高常见症状的诊断能力以及更安全的操作，获得 POCUS 的基本技能可能会改善患者的护理。POCUS 将被纳入本科、内科和肾病学培训课程，这可能会导致该技术逐渐引入 ESRD 患者的护理中。
