Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Adv Chronic Kidney Dis. 2021 May;28(3):252-261. doi: 10.1053/j.ackd.2021.03.004.
Organ dysfunction in the setting of heart failure is mainly determined by backward transmission of increased right atrial pressure. Although traditional point-of-care ultrasound applications such as inferior vena cava and lung ultrasound have been increasingly incorporated in the clinical care of congestive heart failure, they do not directly evaluate the hemodynamic consequences of high right atrial pressure on organ blood flow. Congestion induces alterations in the venous flow patterns of abdominal organs that can be readily assessed using Doppler imaging. These alterations have been consistently associated with congestive organ dysfunction and adverse clinical outcomes. In this article, we provide a comprehensive overview of the bedside assessment of venous congestion using Doppler imaging. The review focuses mainly on the normal and abnormal Doppler patterns of the hepatic, portal, and intrarenal veins along with clinical examples of how to incorporate this tool in the management of patients with venous congestion.
心力衰竭时的器官功能障碍主要取决于增加的右心房压力的逆向传递。尽管传统的即时护理超声应用，如下腔静脉和肺部超声，已越来越多地纳入充血性心力衰竭的临床护理中，但它们并不能直接评估高右心房压力对器官血流的血流动力学后果。充血会引起腹部器官静脉血流模式的改变，这些改变可以通过多普勒成像来进行评估。这些改变与充血性器官功能障碍和不良临床结局密切相关。在本文中，我们提供了使用多普勒成像对床边静脉充血进行全面评估的概述。综述主要集中在肝、门静脉和肾内静脉的正常和异常多普勒模式，以及如何将该工具纳入静脉充血患者管理的临床实例。
