Next Article in Journal
Use of Complementary and Alternative Medicine by Patients with Irritable Bowel Syndrome According to the Roma IV Criteria: A Single-Center Italian Survey
Previous Article in Journal
Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan
Open AccessArticle

Lung Ultrasound B-lines Occurrence in Relation to Left Ventricular Function and Hydration Status in Hemodialysis Patients

1
Dialysis Centre, Fresenius Nephrocare, 34-600 Limanowa, Poland
2
Department of Internal Medicine, District Hospital, 34-600 Limanowa, Poland
3
Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, 40-027 Katowice, Poland
4
Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(2), 45; https://doi.org/10.3390/medicina55020045
Received: 9 January 2019 / Revised: 6 February 2019 / Accepted: 7 February 2019 / Published: 12 February 2019
  |  
PDF [451 KB, uploaded 12 February 2019]
  |     |  

Abstract

Background and objective: Reliable assessment of the fluid status in hemodialysis (HD) patients is often difficult. A lung ultrasound with an assessment of the B-lines (“lung comets” (LCs)) number is a novel hydration status measure. However, the occurrence of left ventricular dysfunction may have a significant effect on pulmonary congestion and further modulate the LC number. The aim of this study was to analyze to what extent left ventricular dysfunction, pulmonary hypertension, and hypervolemia affect the occurrence of LC in a cohort of prevalent HD patients. Material and methods: This cross-sectional study included 108 assessments performed in 54 patients who attended thrice weekly outpatient HD. Each patient’s fluid status was evaluated twice, prior to HD sessions, using echocardiography, LC number assessment, measurement of inferior vena cava (IVC) diameters, and bioelectric impedance analysis (BIA). Patients were stratified into three subgroups according to their LC number. Results: There were 76 separate assessments with mild (<14), 16 with moderate (14–30), and 16 with severe (>30) LC occurrence. There was a negative correlation between the LC number and left ventricular ejection fraction (LVEF), and positive correlations between the LC number and mitral gradient, and the left and right atrium area and volume, but not with the BIA-derived relative fluid overload. Multivariate linear regression analysis revealed that the LC number was proportionally related to the mitral gradient (β = 0.407 (0.247–0.567), p < 0.001) and IVC max diameter (β = 0.219 (0.060–0.378), p < 0.01), and was inversely related to LVEF (β = −0.431 (−0.580 to −0.282), p < 0.001). Conclusions: The number of LCs appears to reflect both overhydration and left ventricular dysfunction in our HD patients cohort. Therefore, heart failure must be considered as an important factor limiting the usefulness of LCs number assessment in this population. View Full-Text
Keywords: bioimpedance analysis; echocardiography; chronic kidney disease; left ventricular ejection fraction; lung comets; lung ultrasound; overhydration bioimpedance analysis; echocardiography; chronic kidney disease; left ventricular ejection fraction; lung comets; lung ultrasound; overhydration
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Pardała, A.; Lupa, M.; Chudek, J.; Kolonko, A. Lung Ultrasound B-lines Occurrence in Relation to Left Ventricular Function and Hydration Status in Hemodialysis Patients. Medicina 2019, 55, 45.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Medicina EISSN 1010-660X Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top