William Beaubien-Souligny1, Maxime Rhéaume2, Marie-Christine Blondin3, Shérine El-Barnachawy4, Annik Fortier5, Jean Éthier6, Louis Legault6, André Y Denault7,8. 1. Department of Medicine, Université de Montréal, Montreal, Québec, Canada. 2. Department of Medicine, Hôpital Sacré-Coeur de Montréal, Montreal, Québec, Canada. 3. Department of Geriatric Medicine, Hôpital Pierre-Boucher, Montreal, Québec, Canada. 4. Department of Medicine, CISSS de la Gaspésie, Gaspé, Québec, Canada. 5. Montreal Health Innovation Coordinating Center, Montreal, Québec, Canada. 6. Departement of Nephrology, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada. 7. Department of Anesthesia, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada. 8. Division of Critical Care Medicine Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada.
Abstract
BACKGROUND: Fluid overload leading to pulmonary congestion is an important issue in patients undergoing hemodialysis. This study aimed to determine if a simplified method of extravascular lung water assessment using ultrasound provided clinically relevant information. METHODS: This prospective study recruited 47 patients from a single hemodialysis center. Pulmonary ultrasound was performed before and after 2 hemodialysis sessions in 28 regions on the thorax. The B-line score was defined as the percentage regions where B-lines were present. RESULTS: When B-lines were detected before hemodialysis, a significant relationship was found between fluid removal and the change in B-line score. Patients with a B-line score of ≥21.4% (4th quartile) after the second hemodialysis session were more likely to be hospitalized for pulmonary edema or acute coronary syndrome. CONCLUSIONS: A simplified pulmonary assessment using ultrasound provides relevant information about pulmonary congestion in hemodialysis patients and identifies patients at risk of hospitalization for heart-related problems.
BACKGROUND: Fluid overload leading to pulmonary congestion is an important issue in patients undergoing hemodialysis. This study aimed to determine if a simplified method of extravascular lung water assessment using ultrasound provided clinically relevant information. METHODS: This prospective study recruited 47 patients from a single hemodialysis center. Pulmonary ultrasound was performed before and after 2 hemodialysis sessions in 28 regions on the thorax. The B-line score was defined as the percentage regions where B-lines were present. RESULTS: When B-lines were detected before hemodialysis, a significant relationship was found between fluid removal and the change in B-line score. Patients with a B-line score of ≥21.4% (4th quartile) after the second hemodialysis session were more likely to be hospitalized for pulmonary edema or acute coronary syndrome. CONCLUSIONS: A simplified pulmonary assessment using ultrasound provides relevant information about pulmonary congestion in hemodialysis patients and identifies patients at risk of hospitalization for heart-related problems.