Parulekar Prashant, Neil-Gallacher Ed, Harrison Alex
Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
J Intensive Care Soc. 2018 Nov;19(4):313-318. doi: 10.1177/1751143718762685. Epub 2018 Mar 8.
Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.
急性肾损伤在重症患者中很常见，建议进行超声检查以排除尿路梗阻。重症监护病房的临床医生擅长获取和解读超声检查结果。重症医学实习生希望学习尿路超声检查。我们试图证明重症监护病房的临床医生能够胜任对重症患者进行尿路超声检查。两名重症监护病房医生使用标准的重症监护病房超声仪对30例急性肾损伤患者进行了扫描。存档图像由一名放射科医生评估其充分性和诊断质量。30例患者中有28例双侧肾脏被识别。30例患者中有23例能够获得双肾在两个平面上的充分存档图像。检查失败的最常见原因是腹部手术的敷料和引流管。只有1例患者有肾积水。我们的结果表明，重症监护病房的临床医生可以提供有针对性的尿路超声检查。肾积水的低发病率对重症监护核心超声技能的培训有一定影响。
