Use of power Doppler ultrasound to monitor renal perfusion during burn shock.
BACKGROUND
Renal cortical blood flow can be quantified by means of power Doppler ultrasound (PDUS) image analysis. We hypothesized that renal cortical perfusion, estimated by PDUS image intensity (PDUSII), would decrease during burn shock and improve during resuscitation in a porcine model.


METHODS
Eight anesthetized swine sustained a 75% scald injury. Resuscitation began 6h postburn. Renal cortical blood flow was measured directly using fluorescent microspheres (CORFLO), and was estimated noninvasively by PDUSII. PDUSII, CORFLO, and cardiopulmonary data were recorded every 2h.


RESULTS
PDUSII decreased significantly from preburn to postburn hour 6, and increased with resuscitation by hour 8. CORFLO correlated well with PDUS image intensity (n=48, r(2)=0.696) but poorly with urine output (n=48, r(2)=0.252).


CONCLUSIONS
PDUS in this study was superior to the urine output in assessing renal cortical microvascular blood flow during shock and resuscitation, and may be useful in the care of injured patients.
Kuwa
Toshiyuki
T
Trauma and Critical Care Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya City, Hyogo, Japan.
Jordan
Bryan S
BS
Cancio
Leopoldo C
LC
D000818:Animals; D002056:Burns / Q000503:physiopathology*; D008297:Male; D008863:Microspheres; D012079:Renal Circulation / Q000502:physiology*; D012774:Shock, Traumatic / Q000503:physiopathology*; D013552:Swine; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance / Q000502:physiology