Accurate bedside clinical assessment of hypertensive and 'symptomatic' hypotensive patient's intravascular volume status with hand-carried ultrasound devices in hemodialysis clinic

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Zhang, Yiyang
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The number of people diagnosed and living with kidney failure requiring dialysis in Canada has tripled in the last two decades. In center hemodialysis is a thrice-weekly treatment that attempts to remove fluid and toxins rapidly and in a short time. One of the major difficulties is determining how much fluid to remove from a patient in a given treatment as the bedside physical exam is often inaccurate. Therefore the aim of this study is to assess volume status in chronic dialysis patients by measuring the IVC diameter employing a hand-carried ultrasound. Patients with kidney failure were recruited to the study and each was scanned three times on three different dialysis sessions. Measurements of the inferior vena cava were taken pre, mid, and post dialysis sessions. Measurements of the inferior vena cava were compared to clinical surrogates of volume, which include blood pressure, symptoms, and ultrafiltration removed. The student learnt ultrasound techniques to scan for the inferior vena cava, as well, he learnt basic research and statistical skills in order to assess the reliability and feasibility of using hand-carried ultrasound in clinical practice.