Bedside Ultrasound in the Management of Cardiorenal Syndromes: An Updated Review.

Eduardo R Argaiz, Gregorio Romero-Gonzalez, Philippe Rola, Rory Spiegel, Korbin H Haycock, Abhilash Koratala

Journal: Cardiorenal medicine 2023;13(1):372-384

PMID: 37980889

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Abstract

BACKGROUND

Cardiorenal syndromes constitute a spectrum of disorders involving heart and kidney dysfunction modulated by a complex interplay of neurohormonal, inflammatory, and hemodynamic derangements. The management of such patients often poses a diagnostic and therapeutic challenge to physicians owing to gaps in understanding of pathophysiology, paucity of objective bedside diagnostic tools, and individual biases.

SUMMARY

In this narrative review, we discuss the role of clinician who performed bedside ultrasound in the management of patients with cardiorenal syndromes. Novel sonographic applications such as venous excess ultrasound score (VExUS) are reviewed in addition to the lung and focused cardiac ultrasound. Further, underrecognized causes of heart failure such as high-flow arteriovenous fistula are discussed.

KEY MESSAGE

Bedside ultrasound allows a comprehensive hemodynamic characterization of cardiorenal syndromes.

Address: Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico, [email protected].; Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico, [email protected].; Nephrology Department, University Hospital Germans Trias i Pujol, Badalona, Spain.; International Renal Research Institute of Vicenza, Vicenza, Italy.; Intensive Care Unit, Hopital Santa Cabrini Ospedale CEMTL, Montreal, Québec, Canada.; Department of Critical Care, Georgetown University Medstar Washington Hospital Center, Washington, District of Columbia, USA.; Department of Emergency Medicine, Loma Linda University Health, Loma Linda, California, USA.; Department of Emergency Medicine, Riverside University Health System, Moreno Valley, California, USA.; Division of Nephrology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

DOI: 10.1159/000534976

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MeSH Terms: Humans, Cardio-Renal Syndrome, Heart Failure, Heart, Ultrasonography, Hemodynamics