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The agreement between auscultation and lung ultrasound and effect of a dry-weight probing guided by lung ultrasound on blood pressure in hemodialysis patients
Slovenia (SloMSIC) - University of Maribor, Maribor
Clinic for Internal Medicine, Department of Dialysis,
Assoc. Prof. Robert Ekart, M.D., Ph.D.
Assoc. Prof. Robert Ekart, M.D., Ph.D.
English or German
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Identifying an accurate and objective method of dry weight evaluation has been a matter of intensive nephrology research for more than two decades. Assessment of the water balance in hemodialysis patients on the basis of common clinical criteria (eg. leg or face swelling or signs of lung congestion) is a subjective method with limited reliability, despite its widespread use. Ultrasonographic estimation of accumulated water in lung interstitium has been already used effectively in the evaluation of intravascular volume status in patients hospitalized in intensive care units, as well as in patients with heart failure. Accumulation of fluid in the lung is the most concerning sequela of volume expansion and also hypertension in end stage renal disease (ESRD) patients.
What is the aim of the project?
The main aim of this study is to investigate whether a treatment strategy based lung congestion measured by lung ultrasound (US-B lines) to guide dry-weight probing and ultrafiltration intensification will affect systolic and diastolic blood pressure before and after hemodialysis in ESRD patients with hypertension undergoing maintenance hemodialysis.
What techniques and methods are used?
Lung water assessment by chest US is a quick, reliable, and easy to learn technique that requires just a 2-hours training session. Lung US is a fast (< 5 min.), easy to learn, simple and non-expensive technique which measures extra-vascular lung water by using standard ultrasound US machines.
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
In first two days the student will study the literature about lung ultrasound, watch the video and clinical presentation by myself. Then, student will discuss the topic with tutor. Later, the student will be observing my working in order to learn the technique. Then in next two days he/she will provide US in minimum 5 ESRD patients under my supervision. In next 3 weeks, student will perform lung US in stable ESRD patients with hypertension on chronic hemodialysis and in patients with pulmonary congestion at pre-dialysis baseline (>5 US-B lines) under my supervision. After 3 weeks he/she will statistically analyse the results.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
The student have to read some articles from the field of lung ultrasound and watch a video and clinical presentation.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a poster - The student will prepare a presentation - The student will have the opportunity to present the results together with the supervisor at a conference
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Lung and heart auscultation skills. x Subjects passed: Internal Medicine, Radiology x Previous experience with: Ultrasound
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- Torino C; Gargani L; Sicari R; et al: The agreement between auscultation and lung ultrasound in hemodialysis patients: the LUST study. Clin J Am Soc Nephrol 2016;11(11):2005-2011. Epub 2016 Sep 22. doi: 10.2215/CJN.03890416
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