Abstract: SA-PO930

Lung Ultrasound in ESRD: Moving from Evidence to Practice

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Ross, Daniel W., Hofstra Northwell School of Medicine, Great Neck, New York, United States
  • Abbasi, Mohammed, Montefiore Medical Center, Bronx, New York, United States
  • Jhaveri, Kenar D., Hofstra Northwell School of Medicine- Northwell health system, Great neck, New York, United States
  • Sachdeva, Mala, None, Great Neck, New York, United States
  • Barnett, Richard L., None, Great Neck, New York, United States
  • Narasimhan, Mangala, Northwell, Sleepy Hollow, New York, United States
  • Mathew, Anna, North Shore-LIJ Health System, Great Neck, New York, United States
Background


Lung ultrasound (US) allows for enhanced ability to detect extravascular lung water compared to traditional physical exam or standard chest XRay. This is extremely important for our CKD and ESRD patients to assess volume status. Training in using point of care US that includes lung US is vital in this era for our fellows and faculty. We conducted a review of lung US use in dialysis patients and assessed how it was taught to researchers.


Methods

We conducted a strategic search in Medline, Embase, Cochrane, and Web of Science. Eligibility criteria for included studies were: (1) 5 or more adults (age ≥ 18) with ESRD on chronic dialysis; (2) measured and reported lung US findings; and (3) reported another comparator outcome measure of volume status. Articles that looked at only IVC and not lung US were excluded. Titles and abstracts were screened by a single reviewer and the remaining full texts were reviewed independently by two reviewers. Discrepancies were resolved by a third reviewer.

Results

We identified 1,249 articles of potential interest. After title and abstract screening, we reviewed 352 full-text articles. We identified 12 studies where lung US was used to detect extravascular lung water in dialysis patients. In two studies nephrologists were trained but in most studies residents were trained. Reported training time varied from 2 to 3 hours. Time to perform lung US ranged from 6 to 15 minutes. All studies reported high concordance between novice and expert sonographers.

Conclusion

Lung US can be reliably taught to learners in a short 2 to 3-hour training course. Teaching lung US to our nephrology trainees is an important step to improve care collaboration with our critical care and emergency medicine colleagues and improving volume assessment in our CKD and ESRD patients.