The use of lung ultrasound in evaluation of extravascular lung water in hemodialysis patients: Systematic review and meta-analysis

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY Hemodialysis International Pub Date : 2024-02-27 DOI:10.1111/hdi.13141

Anas Elgenidy, Mostafa Atef Amin, Ahmed K. Awad, Abdullah Emad, Abdelrahman Nassar, Omar Alomari, Radwa Ibrahim, Faeq Husain-Syed, Mostafa G. Aly

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Abstract

Rationale and Objectives

Determining dry weight is crucial for optimizing hemodialysis, influencing efficacy, cardiovascular outcomes, and overall survival. Traditional clinical assessment methods for dry weight, relying on factors such as blood pressure and edema, frequently lack reliability. Lung ultrasound stands out as a promising tool for assessing volume status, given its non-invasiveness and reproducibility. This study aims to explore the role of Lung ultrasound in evaluating the impact of hemodialysis and ultrafiltration on extravascular lung water, with a specific focus on changes in B-lines post-hemodialysis compared to pre-hemodialysis.

Materials and Methods

The research encompassed searches across PubMed, WOS, and Scopus databases for studies related to lung ultrasound and hemodialysis. A meta-analysis was then performed to determine the mean differences in various parameters before compared to after, hemodialysis, including the number of B-lines, indexed end-inspiratory and end-expiratory inferior vena cava diameters, inferior vena cava collapsibility index, weight, blood pressure, and serum levels of NT-pro-BNP.

Results

Our meta-analysis, included 33 studies with 2301 hemodialysis patients, revealed a significant decrease in the number of B-lines post-hemodialysis (mean difference = 8.30, 95% CI [3.55 to 13.05]). Furthermore, there was a noteworthy reduction in inspiratory and expiratory inferior vena cava diameters post-hemodialysis (mean difference = 2.32, 95% CI [0.31 to 4.33]; mean difference = 4.05, 95% CI [2.44 to 5.65], respectively). Additionally, a significant positive correlation was observed between B-lines and the maximum inferior vena cava diameter both pre- and post-hemodialysis (correlation coefficient = 0.39; correlation coefficient = 0.32, respectively).

Conclusion

These findings indicate the effectiveness of lung ultrasound in detection of volume overload and assessment of response to ultrafiltration in hemodialysis patients.

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使用肺部超声评估血液透析患者的血管外肺水：系统回顾和荟萃分析。

理由和目标：确定干体重对于优化血液透析至关重要，会影响疗效、心血管预后和总体存活率。传统的干体重临床评估方法依赖于血压和水肿等因素，往往缺乏可靠性。肺部超声因其无创性和可重复性而成为评估肺容量状态的理想工具。本研究旨在探讨肺部超声在评估血液透析和超滤对血管外肺水影响方面的作用，重点关注血液透析后与透析前相比 B 线的变化：研究包括在 PubMed、WOS 和 Scopus 数据库中搜索与肺部超声和血液透析相关的研究。然后进行了一项荟萃分析，以确定血液透析前与血液透析后各种参数的平均差异，包括 B 线数量、吸气末和呼气末下腔静脉直径指数、下腔静脉塌陷指数、体重、血压和血清 NT-pro-BNP 水平：我们的荟萃分析包括 33 项研究，涉及 2301 名血液透析患者，结果显示血液透析后 B 线数量显著减少（平均差异 = 8.30，95% CI [3.55 至 13.05]）。此外，血液透析后吸气和呼气下腔静脉直径明显缩小（平均差=2.32，95% CI [0.31至4.33]；平均差=4.05，95% CI [2.44至5.65]）。此外，在血液透析前和血液透析后，B线与下腔静脉最大直径之间均存在明显的正相关性（相关系数=0.39；相关系数=0.32）：这些研究结果表明，肺部超声在检测血液透析患者容量超负荷和评估超滤反应方面非常有效。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.