Read on Twitter
#POCUS case:
Patient with CKD admitted with HF exacerbation. Started on IV diuretics. Scr
, wt 
by 0.5 kg, urine ~700cc (12 hr) Pt felt 'OK'
Dr. A: "she is intravascularly dry,diuretic"
Dr. B: "diuretic"
Whoz correct? #VExUS images in thread
#Nephrology #MedEd
Patient with CKD admitted with HF exacerbation. Started on IV diuretics. Scr
, wt by 0.5 kg, urine ~700cc (12 hr) Pt felt 'OK'Dr. A: "she is intravascularly dry,
diuretic"Dr. B: "
diuretic"Whoz correct? #VExUS images in thread
#Nephrology #MedEd
EF obviously low. There is some TR, mitral annular calcification (CKD).
IVC >2.5 cm, minimal respiratory variation - high right atrial pressure
Next step: #VExUS Hepatic vein color #POCUS
Next step: #VExUS Hepatic vein color #POCUS
Police siren 
pattern (red-blue-red-blue).
Spectral Doppler image with EKG
Note RAP meter on the top!
pattern (red-blue-red-blue).Spectral Doppler image with EKG
Note RAP meter on the top!
Portal vein color #VExUS
Its flickery with some 'blue' component (= pulsatile with flow reversal)
& spectral Doppler is consistent with it
& spectral Doppler is consistent with it
Lung #POCUS showed B-lines in almost all the sono-auscultated zones. Representative image
#POCUS verdict:
Severe congestion, #VExUS grade 3,extra-vascular lung water
Dr. B is correct,+ optimize diuretic therapy, involve cardiology
Severe congestion, #VExUS grade 3,
extra-vascular lung waterDr. B is correct,
+ optimize diuretic therapy, involve cardiology
