The Role of Point-of-Care Ultrasound Monitoring in Cardiac Surgical Patients With Acute Kidney Injury

J Cardiothorac Vasc Anesth. 2019 Oct;33(10):2781-2796. doi: 10.1053/j.jvca.2018.11.002. Epub 2018 Nov 3.

Abstract

The approach to the patient with acute kidney injury (AKI) after cardiac surgery involves multiple aspects. These include the rapid recognition of reversible causes, the accurate identification of patients who will progress to severe stages of AKI, and the subsequent management of complications resulting from severe renal dysfunction. Unfortunately, the inherent limitations of physical examination and laboratory parameter results are often responsible for suboptimal clinical management. In this review article, the authors explore how point-of-care ultrasound, including renal and extrarenal ultrasound, can be used to complement all aspects of the care of cardiac surgery patients with AKI, from the initial approach of early AKI to fluid balance management during renal replacement therapy. The current evidence is reviewed, including knowledge gaps and future areas of research.

Keywords: Doppler ultrasound; acute kidney injury; cardiac surgery; point-of-care ultrasound.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / diagnostic imaging*
  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / physiopathology
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiac Surgical Procedures / methods
  • Humans
  • Monitoring, Intraoperative / methods*
  • Point-of-Care Systems*
  • Ultrasonography, Interventional / methods*