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Congress: ECR24
Poster Number: C-13427
Type: EPOS Radiologist (scientific)
DOI: 10.26044/ecr2024/C-13427
Authorblock: M. Vaccaro1, A. Vassallo1, C. Corrado1, M. M. D'Alessandro1, A. G. Delmonaco2, G. Pavone1, S. Salerno1, G. Paviglianiti1; 1Palermo/IT, 2Torino/IT
Disclosures:
Marzia Vaccaro: Nothing to disclose
Alessia Vassallo: Nothing to disclose
Ciro Corrado: Nothing to disclose
Maria Michela D'Alessandro: Nothing to disclose
Angelo Giovanni Delmonaco: Nothing to disclose
Giovanni Pavone: Nothing to disclose
Sergio Salerno: Nothing to disclose
Giuseppe Paviglianiti: Nothing to disclose
Keywords: Kidney, Paediatric, Veins / Vena cava, Ultrasound, Ultrasound-Spectral Doppler, Diagnostic procedure, Haemodynamics / Flow dynamics, Oedema
Purpose An adequate assessment of intravascular volume is necessary to optimize targeted therapy in pediatric patients with kidney disease. The Venous Excess Ultrasound (VExUS) score is a new Doppler POCUS protocol recently applied in adults with heart disease as a system for assessing and classifying volemic status [1]. In this study we applied the VExUS ultrasound protocol in a nephropathic pediatric population (without heart disease) in the evaluation of their hemodynamic status.
Read more Methods and materials Four children (2 boys and 2 girls, mean age 6.2 years), affected by renal pathologies characterized by volume overload (glomerulonephritis, nephrotic syndrome and chronic end-stage renal failure) were included in the study. Clinical and laboratory parameters such as the presence of edema, body weight, and diuresis were evaluated. All patients performed an abdominal ultrasound scan integrated with the 4-step VExUS protocol, which was useful for identifying venous congestion (VExUS score). The first step is the assessment of the inferior vena...
Read more Results We performed Vexus in 2 patients with Chronic Renal Failure on dialysis, in one patient with glomerulonephritis and in one patient affected by nephrotic syndrome. In our study, we documented VExUS signs of venous congestion in patients without any ultrasound signs of hypervolemia. All patients underwent doppler assessment before starting treatment and ten days later of therapy; in this period the VexUS score, normalized in association with an improvement in clinical-laboratory parameters.
Read more Conclusion In our experience the VExUS score can be used effectively in children with kidney disease. We applied the VExUS to the pediatric population, which is different from adults for which the score was created, but we noted its efficacy in this group of patients to estimate fluid overload. Based on the results of this study, we propose this score to estimate the ideal dialysis weight to prevent intradialytic symptoms (cramps, hypotension) [7,8]. We need further studies with a larger number...
Read more References 1. Beaubien-Souligny W, Rola P, Haycock K, Bouchard J, Lamarche Y, Spiegel R, Denault AY. Quantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system. Ultrasound J. 2020 Apr 9;12(1):16. doi: 10.1186/s13089-020-00163-w. PMID: 32270297; PMCID: PMC7142196.2. Argaiz ER, Koratala A, Reisinger N. Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography. Kidney360. 2021 May 27;2(8):1326-1338. doi: 10.34067/KID.0006482020. PMID: 35369665; PMCID: PMC8676400.3. www.pocus101.com/vexus-ultrasound-score-fluid-overload-and-venous-congestion-assessment/4. de Valk S, Olgers TJ, Holman M, Ismael F, Ligtenberg JJ, Ter Maaten JC. The...
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