Lung ultrasound methods for assessing fluid volume change and monitoring dry weight in pediatric hemodialysis patients
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ORIGINAL ARTICLE
Lung ultrasound methods for assessing fluid volume change and monitoring dry weight in pediatric hemodialysis patients Qian Fu 1 & Zhi Chen 1 & Jianfeng Fan 1 & Chen Ling 1 & Xiaoman Wang 2 & Xiaorong Liu 1 & Ying Shen 1 Received: 6 May 2020 / Revised: 17 July 2020 / Accepted: 29 July 2020 # IPNA 2020
Abstract Background The value of lung ultrasound in adult hemodialysis has been confirmed. The determination of dry weight in children remains challenging. This study explores the usefulness of lung ultrasound in assessing fluid volume change and the possibility of pulmonary ultrasound as a method to monitor dry weight in pediatric dialysis patients. Methods This was a prospective observational study. We compared the predialysis and postdialysis B-line scores of the dryweight group and non-dry-weight group. Changes in body weight and B-line scores were recorded during the dialytic period and interdialytic period, and the correlation was analyzed. Lung ultrasound was performed after the dialysis session every Friday, and B-line score < 10 was considered to indicate that there was no volume overload; the weight was recorded as the target weight. Results Fourteen patients were included. A total of 78 ultrasound assessments were performed: 30 in the dry-weight group and 48 in the non-dry-weight group. The B-line scores decreased after dialysis in all patients (p < 0.001). Thirty-three assessments were performed in the interdialytic period, and 40 assessments in the dialytic period were performed within 1 week. Linear regression showed that changes in B-line number were directly and positively correlated with interdialytic weight gain (r = 0.517, p = 0.002) and dialytic weight loss (r = 0.558, p < 0.001). The weight of the children increased gradually without volume overload in two patients during follow-up. Conclusion Lung ultrasound can assess the fluid volume change of pediatric dialysis patients in real time. Lung ultrasound could be a valuable method for monitoring dry weight in pediatric dialysis patients. Keywords Lung ultrasound . Children . Dry weight . Dialysis
Introduction Dry weight is one of the primary treatment goals for hemodialysis patients. The definition of dry weight by Sinha and Agarwal is widely accepted at present [1]. Dry weight is a Xiaorong Liu and Ying Shen contributed equally to this work. * Xiaorong Liu [email protected] * Ying Shen [email protected] 1
Department of Nephrology, Beijing Children’s Hospital Affiliated to Capital Medical University, Beijing Key Laboratory for Chronic Renal Disease and Blood Purification, National Center for Children’s Health, West District Nan Li Shi Lu 56th, Beijing 100045, China
2
Department of Ultrasound, Beijing Children’s Hospital Affiliated to Capital Medical University, National Center for Children’s Health, West District Nan Li Shi Lu 56th, Beijing 100045, China
volumetric state without hypovolemia or hypervolemia. Chronic hypovolemia and hypervolemia due to an incorrect estimation of dry weight can lead to chronic dehydration or lo
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