Critical Care Ultrasound: A Review for Practicing Nephrologists.
The use of point-of-care ultrasound in the intensive care unit, both for diagnostic and procedural purposes, has rapidly proliferated, and evidence supporting its use is growing. Conceptually, critical care ultrasound (CCUS) should be considered an extension of the physical examination and should not be considered a replacement for formal echocardiography or radiology-performed ultrasound. Several CCUS applications are of particular relevance to nephrologists, including focused renal ultrasound in patients at high risk for urinary tract obstruction, real-time ultrasound guidance and verification during the placement of central venous catheters, and ultrasound-augmented assessment of shock and volume status. Each of these applications has the capacity to improve outcomes in patients with acute kidney injury. Although robust evidence regarding long-term outcomes is lacking, existing data demonstrate that CCUS has the potential to improve diagnostic accuracy, expedite appropriate management, and increase safety for critically ill patients across a spectrum of pathologies.
Division of Critical Care Medicine, Department of Emergency Medicine, University of California San Francisco, San Francisco, CA; and Division of Critical Care Medicine, Department of Anesthesia, University of California San Francisco, San Francisco, CA. Electronic address: Jenny.wilson@ucsf.edu.
Jennifer G
JG
Wilson
Division of Critical Care Medicine, Department of Emergency Medicine, University of California San Francisco, San Francisco, CA; and Division of Critical Care Medicine, Department of Anesthesia, University of California San Francisco, San Francisco, CA.
Kristine E W
KE
Breyer
D058186:Acute Kidney Injury / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000379:methods*; D003422:Critical Care; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D020896:Hypovolemia / Q000000981:diagnostic imaging; D007668:Kidney / Q000000981:diagnostic imaging*; D000072104:Nephrologists; D000067716:Point-of-Care Testing; D012769:Shock / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
Central venous catheter; Critical care; Shock; Ultrasound