The ultrasound journal
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The ultrasound journal · Jun 2020
Point-of-care ultrasound for the detection of hydronephrosis in emergency department patients with suspected renal colic.
Point-of-care ultrasound (PoCUS) by emergency physicians for renal colic has been proposed as an alternative to computed tomography (CT) to avoid ionizing radiation exposure and shorten emergency department length of stay. Previous studies have employed experienced or credentialed ultrasonographers or required advanced ultrasound skills. We sought to measure the diagnostic accuracy of PoCUS by physicians with varied experience using a simplified binary outcome of presence or absence of hydronephrosis. Secondary outcomes include assessment as to whether the presence of hydronephrosis on PoCUS is predictive of complications, and to evaluate possible causes for the reduced diagnostic accuracy such as body mass index (BMI) and time between PoCUS and formal imaging, and scanner experience. ⋯ PoCUS for hydronephrosis in suspected renal colic has moderate accuracy when performed by providers with varied experience for the binary outcome of presence or absence of hydronephrosis. Hydronephrosis on PoCUS is associated with increased rates of complications. PoCUS for hydronephrosis is limited in its utility as a stand-alone test, however this inexpensive, readily available test may be useful in conjunction with clinical course to determine which patients would benefit from formal imaging or urologic consultation. ClinicalTrials.gov Identifier NCT01323842.
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The ultrasound journal · Jun 2020
ReviewRole of point-of-care ultrasound during the COVID-19 pandemic: our recommendations in the management of dialytic patients.
COVID-19 is a viral disease due to the infection of the novel Corona virus SARS-CoV-2, that has rapidly spread in many countries until the World Health Organization declared the pandemic from March 11, 2020. Elderly patients and those affected by hypertension, diabetes mellitus, and chronic pulmonary and cardiovascular conditions are more susceptible to present more severe forms of COVID-19. These conditions are often represented in dialytic renal end-stage patients. ⋯ Growing evidences, although still supported by few publications, are showing the potential utility of ultrasound in patients with COVID-19. In this review, we share our experience in using point-of-care ultrasound, particularly lung ultrasound, to indicate the probability of COVID-19 in patients with end-stage renal disease treated by hemodialysis. We also propose recommendations for the application of lung ultrasound, focused echocardiography and inferior vena cava ultrasound in the management of patients in hemodialysis.