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Erschienen in:
16.10.2020 | Original Article
Lung ultrasound methods for assessing fluid volume change and monitoring dry weight in pediatric hemodialysis patients
Erschienen in: Pediatric Nephrology | Ausgabe 4/2021
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Background
The value of lung ultrasound in adult hemodialysis has been confirmed. The determination of dry weight in children remains challenging. This study explores the usefulness of lung ultrasound in assessing fluid volume change and the possibility of pulmonary ultrasound as a method to monitor dry weight in pediatric dialysis patients.
Methods
This was a prospective observational study. We compared the predialysis and postdialysis B-line scores of the dry-weight group and non-dry-weight group. Changes in body weight and B-line scores were recorded during the dialytic period and interdialytic period, and the correlation was analyzed. Lung ultrasound was performed after the dialysis session every Friday, and B-line score < 10 was considered to indicate that there was no volume overload; the weight was recorded as the target weight.
Results
Fourteen patients were included. A total of 78 ultrasound assessments were performed: 30 in the dry-weight group and 48 in the non-dry-weight group. The B-line scores decreased after dialysis in all patients (p < 0.001). Thirty-three assessments were performed in the interdialytic period, and 40 assessments in the dialytic period were performed within 1 week. Linear regression showed that changes in B-line number were directly and positively correlated with interdialytic weight gain (r = 0.517, p = 0.002) and dialytic weight loss (r = 0.558, p < 0.001). The weight of the children increased gradually without volume overload in two patients during follow-up.
Conclusion
Lung ultrasound can assess the fluid volume change of pediatric dialysis patients in real time. Lung ultrasound could be a valuable method for monitoring dry weight in pediatric dialysis patients.