ISN-ASDIN Webinar: Emerging Trends in POCUS-Based Volume Assessment for the Nephrologist

The goals of volume management encompass accurate assessment of intravascular volume and prediction of responses to interventions such as volume administration, vasopressor support, or volume removal. Ultrasound visualization of variations in the diameter of the inferior vena cava (IVC) during respiration provides a reliable means of evaluating intravascular volume and predicting volume responsiveness. Despite differing physiological mechanisms between IVC respiratory variations in mechanically ventilated and spontaneously breathing patients, the collapsibility index (CI) and distensibility index of the IVC can be interchangeably utilized. In this round-table discussion we will be discussing the clinical utility of IVC CI in various applications throghout nephrology. 

Augmenting ultrasound assessments of the heart, lungs, and abdominal organs, the variations observed through IVC ultrasound offer an additional perspective on issues like venous congestion, volume overload management, deresuscitation, renal failure, dysnatremias, and shock. In this way, VEnous eXcess UltraSonography (VExUS) is currently being developed to address the venous congestion seen in end organs, and will be discussed in theory and application. 

Shifting focus, point of care ultrasound (POCUS) has gained prominence both within and beyond the realm of nephrology. This webinar is dedicated to exploring present and future applications of POCUS within nephrology, specifically delving into its relevance within the dialysis and ICU populations. Furthermore, the webinar aims to tackle the effective pedagogy of POCUS for nephrologists. By fostering discussions and knowledge exchange, this round table session aspires to promote and facilitate the integration of POCUS within nephrological practice.

Learning objectives:

- Review the key principles, advantages, and potential limitations of using IVC ultrasound for the assessment of intravascular volume.
- Discuss the available data supporting the utilization of IVC measurements to guide ultrafiltration prescription and effectively manage intravascular volume in clinical settings.
- Explore the historical development, current status, and potential future advancements in the field of IVC ultrasound, including its role in guiding volume assessment and management.
- Examine the application of Point of Care Ultrasound (POCUS) in the context of hepato-renal syndrome, understanding its relevance, benefits, and potential contributions to patient care.
- Investigate the specific use of IVC ultrasound within the Intensive Care Unit (ICU) environment, comprehending its significance, challenges, and potential impact on patient outcomes.
- Explore the historical development, current status, and potential future advancements in VExUS