Keywords
Chronic renal insufficiency
Ultrasound
Point-of-care
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Abstract
Objective: To compare the reliability of the assessment of pulmonary congestion through auscultation and trough POCUS (point-of-care ultrasound) in hemodialysis patients performed by different examiners: qualified physician and medical academic. Methods: Study in hemodialysis patients at the kidney Pro-Clinic. Comorbidities and clinical signs of congestion al together with ultrasonography were collected, thus scanning eight lung areas to identify the presence of B lines. Results: Of 30 patients, 36.6% of them had peripheral edema and 13.3% a turgor jugular. The prevalence of pulmonary congestion evaluated by the medical professional in the auscultation and in the ultra-sonographic test was 13.3% and 50.0%, respectively. In the evaluation of the academics, both obtained a prevalence of 20% by auscultation, and by ultrasonography it was 60.0% and 50.0%. In the evaluation by auscultation between the doctor and the academics, it can be said that a moderate (k=0.48) and low (k=0.19) concordance, respectively, was detected. In the pulmonary congestion evaluated by the POCUS, a substantial concordance was observed between the doctor and academician 1 (k=0.67), and moderate agreement was observed for academician 2 (k=0.67). Conclusion: For the diagnosis of pulmonary congestion, the POCUS is superior to the auscultation. There is moderate and substantial reliability between the physician and the academics for the POCUS, however, moderate and low agreement is visible on auscultation.
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