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Hemodynamic approach of acute kidney injury (AKI) scenarios are commonly limited to clinical volumen overload evaluation and portal vein pulsatility index (PI). The use of VexUS score could allow real-time assessment of the scenario and predictions in acute settings. We compared the VExUS diagnosis of AKI with usual AKI clinical evaluation.
A single center, prospective, cohort of patients who developed AKI during admission. Outcomes measures were to assess kidney renal recovery, mortality and causes of death. Associations were tested with the Fischer exact test and compare between categories with the Kruskal-Wallis test. A value of p <0.05 was considered statistically significant.
A total of 45 patients were included for the study. VExUS group had a mean age 63 ± 20, eighty one percent of them were males. Fifty percent had a cardiovascular disease. Sixteen patients were in an AKI stage 2. Five had a VExUS grade II. We observed non-significant differences at B-line presence, OR=1.65(1.47-1.83) and clinical outcomes OR=1.56 (1.45-1.69), not the same when comparing to fluid balance, need of RRT, vasopressors use or AKI progression. Also, there was relationship between other assessed variables such as NYHA class, plasma lymphocytes, monocytes, neutrophils, and calcium, showing association between congestion and VExUS grades.
Combining grading ultrasound findings VExUS grades may aid clinical decisions to individualize interventions in critical ill scenarios.