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Minerva Anestesiologica 2021 Oct 28

DOI: 10.23736/S0375-9393.21.15708-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Echocardiography is a good way to diagnose and monitor type 1 cardiorenal syndrome in ICU

Mario GENEIX 1 , Sebastien MOSCHIETTO 2, Antoine FROUIN 2, Fanny DEPEYRE 2, Thibault DUPONT 3, Florent MONTINI 2

1 Medical intensive Care Unit, La Timone Hospital, Assistance publique des Hopitaux de Marseille (APHM), Université Aix-Marseille, Marseille, France; 2 Medical intensive Care Unit, Henry Duffaut Hospital, Avignon, France; 3 Medical intensive Care Unit, Saint Louis Hospital, Assistance publique des Hopitaux de Paris (APHP), Université de Paris, Paris, France


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BACKGROUND: Type one Cardiorenal syndrome (CRS) is defined by acute decompensated heart failure leading to secondary acute kidney injury. No studies evaluates the reliability of transthoracic echocardiography as an help tool for diagnosis and optimization of CRS. Therefore, the aim of this study was to assess echocardiographic parameters in patients with CRS in the Intensive Care Unit.
METHODS: We conducted an observational, prospective, single-center study in the ICU department of a general hospital. Patients admitted in the ICU and presenting with type 1 CRS were included. Transthoracic echocardiography was performed at baseline and at day end after treatment by the same trained operator for the same patients. We report various echocardiographic indices at these two timepoints.
RESULTS: 27 patients were included. At baseline 96.3% of patients had signs of congestion (IVC dilation > 2 cm), 76 % had an altered S-wave (< 11.5 cm/s), 72.73% had an altered TAPSE (< 17 mm), 85.19% had an elevated RV/LV diameter ratio (> 0.6). Between baseline and D end, IVC size and, the number of patients with an elevated RV/LV diameter ratio significantly decreased. Weight decreased, whereas natriuresis significantly increased, and the amount of vasopressors support decreased. Diuresis, and S-wave velocity showed non-significant changes.
CONCLUSIONS: Main echocardiographic findings at baseline in patients with type 1 CRS consist of a right ventricular dysfunction associated an IVC dilation. We report that weight, RV/LV diameter ratio, and IVC diameter might constitute good follow-up parameters to monitor treatment response.


KEY WORDS: Acute kidney injury; Heart failure; Echocardiographic; Intensive care unit

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