Point-of-care ultrasound in Management for Dyspneic Uremic Patients: a case report

• Published in: BMC nephrology Vol. 20; no. 1; p. 463
• Main Authors: Wang, Pei-Hsiu, Lien, Wan-Ching
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.12.2019; BioMed Central; BMC
• Subjects: Case Report; Case reports; Clinical medicine; Creatinine; Diagnosis; Dyspnea; Edema; Effusion; Electrocardiography; Emergency medical care; Etiology; Etiology (Medicine); Family medical history; Heart; Hemodialysis; Kidney diseases; Laboratories; Medical schools; Mortality; Nephrology; Pain; Patient care; Patients; Pericardial effusion; Pericarditis; Physicians; Point-of-care ultrasound; Respiration; Signs; Ultrasonic imaging; Ultrasound; Urea; Uremia; Uremic pericarditis; Urine; United States > US; Uremic pericarditis; Point-of-care ultrasound; Uremia; Pericardial effusion
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-019-1654-x

Point-of-Care Ultrasound (PoCUS) is considered as an extension of clinicians' patient care and can be integrated into daily clinical practice. Dyspnea is a common presentation in uremic patients. With the aids of PoCUS and integrated assessments of lung, heart and inferior vena cava (IVC), the etiology of dyspnea in uremic patients can be determined earlier. A 67-year-old woman presented with progressive shortness of breath and bilateral legs edema for 3 weeks. The laboratory data revealed marked elevated level of serum creatinine and blood urea. A large amount of pericardial effusion was timely detected by PoCUS. Uremic pericarditis was suspected. Emergent hemodialysis was initiated and her symptoms improved. PoCUS is a noninvasive and cost-effective imaging modality and it has been popular in the emergency department (ED). In uremic patients presenting with dyspnea, the integration of PoCUS into traditional physical examinations help emergency physicians narrow down the differential diagnoses.