Produção Nacional
Revisado por pares
Can Nephrologists Use Ultrasound to Evaluate the Inferior Vena Cava A Cross-Sectional Study of the Agreement between a Nephrologist and a Cardiologist
2014; Karger Publishers; Volume: 4; Issue: 1 Linguagem: Inglês
10.1159/000362170
ISSN1664-5529
AutoresJosé Muniz Pazeli, Daniel Fagundes Vidigal, Tarcísio Cestari Grossi, Natália Maria da Silva Fernandes, Fernando Antônio Basile Colugnati, Rogério Baumgratz de Paula, Hélady Sanders-Pinheiro,
Tópico(s)Central Venous Catheters and Hemodialysis
Resumo<b><i>Background/Aims:</i></b> The costs and the need for a specialist impair the implementation of ultrasonography for evaluating the inferior vena cava (IVC) to assess the volemic status in hemodialysis patients. We investigated whether a nephrologist with limited ultrasound training can accurately assess the IVC in patients undergoing hemodialysis. <b><i>Methods:</i></b> A cardiologist and a nephrologist consecutively measured the indexed IVC expiratory diameter (VCDi) and the IVC collapsibility index (IVCCI) of 52 patients during hemodialysis sessions. In protocol I, the nephrologist used a regular ultrasound system (RUS) and the cardiologist used a cardiovascular ultrasound equipment; in protocol II, the machines were interchanged. Pearson and kappa coefficients and the interexaminer agreement by the Bland-Altman method were calculated. <b><i>Results:</i></b> The VCDi measurements showed a strong correlation in both protocols (r = 0.88 and 0.84 in protocols I and II, respectively). The volemic classifications were excellent in protocol I (kappa = 0.82 and 0.93 by VCDi and IVCCI, respectively) and substantial in protocol II (kappa = 0.77 and 0.75 by VCDi and IVCCI, respectively). The interexaminer agreement on the VCDi measurements was very good in both protocols. <b><i>Conclusions:</i></b> Ultrasound evaluation of the IVC can be performed by nephrologists using an RUS to assess the volemic status in hemodialysis patients.
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