title: Bench-to-bedside review: contrast enhanced ultrasonography--a promising technique to assess renal perfusion in the ICU.
abstract: Acute kidney injury (AKI) is common in critically ill patients and associated with important morbidity and mortality. Although alterations in renal perfusion are thought to play a causative role in the pathogenesis of AKI, there is, to date, no reliable technique that allows the assessment of renal perfusion that is applicable in the ICU. Contrast-enhanced ultrasound (CEUS) is an ultrasound imaging technique that makes use of microbubble-based contrast agents. These microbubbles, when injected into the bloodstream, allow visualization of vascular structures and, with contrast-specific imaging modes, detection of blood flow at the capillary level. Some recent CEUS-derived approaches allow quantification of blood flow in several organs, including the kidney. Current generation ultrasound contrast agents have strong stability and safety profiles. Along with post-marketing surveillance, numerous studies report safe administration of these agents, including in critically ill patients. This review presents information on the physical principles underlying CEUS, the methods allowing blood flow quantification and the potential applications of CEUS in critical care nephrology, currently as a research tool but perhaps in the future as a way of monitoring renal perfusion.
authors.affiliation: Intensive Care Unit, Austin Hospital, 145 Studley Road, 3084 Heidelberg, Victoria, Australia.
authors.forename: Antoine
authors.initials: A
authors.lastname: Schneider
authors.forename: Lynne
authors.initials: L
authors.lastname: Johnson
authors.forename: Mark
authors.initials: M
authors.lastname: Goodwin
authors.forename: Anthony
authors.initials: A
authors.lastname: Schelleman
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D058186:Acute Kidney Injury / Q000000981:diagnostic imaging / Q000503:physiopathology; D000818:Animals; D003287:Contrast Media; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging*; D045423:Microbubbles; D019095:Point-of-Care Systems / Q000639:trends; D014463:Ultrasonography
chemical_list: D003287:Contrast Media