Peritoneal Volume Influence on POCUS Volume Assessment in Patients Undergoing Peritoneal Dialysis.

Area of Science:

• Nephrology
• Critical Care Medicine
• Medical Imaging

Background:

• Fluid overload is a common complication in patients undergoing peritoneal dialysis (PD).
• Accurate assessment of fluid status is crucial for managing PD patients and preventing complications.
• Point of care ultrasound (POCUS) offers a non-invasive method for fluid status assessment.

Purpose of the Study:

• To investigate variations in fluid overload assessment using POCUS in PD patients with full versus drained peritoneum.
• To correlate POCUS findings with clinical parameters like intra-abdominal pressure (IAP) and bioimpedance analysis (BIA).

Main Methods:

• POCUS examinations and IAP measurements were performed on 17 PD patients with a full peritoneum.
• After peritoneal fluid drainage, repeat POCUS and BIA were conducted.
• Correlation analysis was performed between ultrasound parameters, IAP, PD fluid volume, and BIA-derived overhydration (OH).

Main Results:

• No statistically significant differences were found in POCUS B-line scores between full and drained peritoneum (p=0.063).
• Intra-abdominal pressure and PD fluid volume did not correlate with inferior vena cava (IVC) diameter or collapsibility.
• Overhydration correlated with IVC collapsibility in the drained state (p=0.02) but not in the full state.

Conclusions:

• POCUS did not show significant differences in detecting fluid overload between full and drained peritoneal states in PD patients.
• Findings suggest potentially lower sensitivity of POCUS for fluid overload detection when the peritoneum is full.