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重症肾脏病学中的肾脏多普勒超声检查。

Kidney Doppler ultrasonography in critical care nephrology.

机构信息

Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.

Department of Pharmacology and Physiology, Karolinska Institutet, Stockholm, Sweden.

出版信息

Nephrol Dial Transplant. 2024 Aug 30;39(9):1416-1425. doi: 10.1093/ndt/gfae103.

Abstract

Color pulsed-wave Doppler ultrasound (CPWD-US) emerges as a pivotal tool in intensive care units (ICUs) for diagnosing acute kidney injury (AKI) swiftly and non-invasively. Its bedside accessibility allows for rapid assessments, making it a primary imaging modality for AKI characterization. Furthermore, CPWD-US serves as a guiding instrument for key diagnostic-interventional procedures such as renal needle biopsy and percutaneous nephrostomy, while also facilitating therapy response monitoring and AKI progression tracking. This review shifts focus towards the integration of renal ultrasound into ICU workflows, offering contemporary insights into its utilization through a diagnostic standard-oriented approach. By presenting a flow chart, this review aims to provide practical guidance on the appropriate use of point-of-care ultrasound in critical care scenarios, enhancing diagnostic precision, patient management and safety, albeit amidst a backdrop of limited evidence regarding long-term outcomes.

摘要

彩色脉冲波多普勒超声(CPWD-US)作为一种重要的工具,在重症监护病房(ICU)中能够快速、无创地诊断急性肾损伤(AKI)。它具有床边可及性,可进行快速评估,是 AKI 特征描述的主要成像方式。此外,CPWD-US 还可作为肾脏针吸活检和经皮肾造口术等关键诊断介入程序的指导工具,同时也便于治疗反应监测和 AKI 进展跟踪。本综述将重点转向将肾脏超声纳入 ICU 工作流程,通过以诊断标准为导向的方法,提供其最新应用的见解。本文通过提供流程图,旨在为重症监护场景中即时超声的合理应用提供实用指导,提高诊断精度、患者管理和安全性,尽管关于长期结果的证据有限。

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