BACKGROUND: Doppler-based renal resistive index (RI) calculation may help in the early detection of acute kidney injury (AKI). Its feasibility and reproducibility by inexperienced operators remain unknown. The main objective of this study was to compare performances of junior and senior operators in assessing renal perfusion using both the semiquantitative color-Doppler scale and RI calculation. METHODS: Prospective cohort study performed in 3 ICUs. Inexperienced juniors physicians attended a half-day course on renal perfusion assessment using RI calculation and color-Doppler (from 0, absence of renal perfusion; to 3, renal vessels identifiable in the entire field of view). Junior and senior operators used both methods in 69 mechanically ventilated patients, in blind fashion. RESULTS: Failure to obtain RI occurred for a junior operator in a single patient. RI and color-Doppler semi-quantitative values obtained by operators were correlated (r²=0.64 and r²=0.61, respectively). Systematic bias across operators as assessed using Bland-Altman plots was negligible (-0.001 and -0.29, respectively), although precision was limited (95% confidence intervals, +0.105 to -0.107 and +0.98 to -1.04, respectively). RI calculation and semi-quantitative assessment performed well for diagnosing persistent AKI (area under the receiver-operating characteristic curve, 0.84 [95% confidence interval, 0.73-0.97] and 0.87 [0.77-0.97], respectively). CONCLUSION: A brief course on renal Doppler allowed inexperienced operators to assess effectively renal perfusion with a good reliability when compared to senior operators. In addition, our results suggest the good diagnostic performance of both Doppler-based RI and semi-quantitative renal perfusion assessment in predicting short-term renal dysfunction reversibility.
BACKGROUND: Doppler-based renal resistive index (RI) calculation may help in the early detection of acute kidney injury (AKI). Its feasibility and reproducibility by inexperienced operators remain unknown. The main objective of this study was to compare performances of junior and senior operators in assessing renal perfusion using both the semiquantitative color-Doppler scale and RI calculation. METHODS: Prospective cohort study performed in 3 ICUs. Inexperienced juniors physicians attended a half-day course on renal perfusion assessment using RI calculation and color-Doppler (from 0, absence of renal perfusion; to 3, renal vessels identifiable in the entire field of view). Junior and senior operators used both methods in 69 mechanically ventilated patients, in blind fashion. RESULTS: Failure to obtain RI occurred for a junior operator in a single patient. RI and color-Doppler semi-quantitative values obtained by operators were correlated (r²=0.64 and r²=0.61, respectively). Systematic bias across operators as assessed using Bland-Altman plots was negligible (-0.001 and -0.29, respectively), although precision was limited (95% confidence intervals, +0.105 to -0.107 and +0.98 to -1.04, respectively). RI calculation and semi-quantitative assessment performed well for diagnosing persistent AKI (area under the receiver-operating characteristic curve, 0.84 [95% confidence interval, 0.73-0.97] and 0.87 [0.77-0.97], respectively). CONCLUSION: A brief course on renal Doppler allowed inexperienced operators to assess effectively renal perfusion with a good reliability when compared to senior operators. In addition, our results suggest the good diagnostic performance of both Doppler-based RI and semi-quantitative renal perfusion assessment in predicting short-term renal dysfunction reversibility.
Authors: Michael Darmon; Aurelie Bourmaud; Marie Reynaud; Stéphane Rouleau; Ferhat Meziani; Alexandra Boivin; Mourad Benyamina; François Vincent; Alexandre Lautrette; Christophe Leroy; Yves Cohen; Matthieu Legrand; Jérôme Morel; Jeremy Terreaux; David Schnell Journal: Intensive Care Med Date: 2018-10-05 Impact factor: 17.440
Authors: Michael Darmon; Marlies Ostermann; Jorge Cerda; Meletios A Dimopoulos; Lui Forni; Eric Hoste; Matthieu Legrand; Nicolas Lerolle; Eric Rondeau; Antoine Schneider; Bertrand Souweine; Miet Schetz Journal: Intensive Care Med Date: 2017-04-25 Impact factor: 17.440
Authors: Tobias Lahmer; Sebastian Rasch; Christopher Schnappauf; Roland M Schmid; Wolfgang Huber Journal: Int Urol Nephrol Date: 2016-05-18 Impact factor: 2.370
Authors: Aiping Zhang; Kitipong Uaesoontrachoon; Conner Shaughnessy; Jharna R Das; Sree Rayavarapu; Kristy J Brown; Patricio E Ray; Kanneboyina Nagaraju; John N van den Anker; Eric P Hoffman; Yetrib Hathout Journal: Toxicol Rep Date: 2015