Bedside Ultrasound in the Management of Cardiorenal Syndromes: An Updated Review

Abstract

Background: Cardiorenal syndromes constitute a spectrum of disorders involving heart and kidney dysfunction modulated by a complex interplay of neurohormonal, inflammatory, and hemodynamic derangements. The management of such patients often poses a diagnostic and therapeutic challenge to physicians owing to gaps in understanding of pathophysiology, paucity of objective bedside diagnostic tools, and individual biases.

Summary: In this narrative review, we discuss the role of clinician who performed bedside ultrasound in the management of patients with cardiorenal syndromes. Novel sonographic applications such as venous excess ultrasound score (VExUS) are reviewed in addition to the lung and focused cardiac ultrasound. Further, underrecognized causes of heart failure such as high-flow arteriovenous fistula are discussed.

Key message: Bedside ultrasound allows a comprehensive hemodynamic characterization of cardiorenal syndromes.

Keywords: Cardiorenal syndrome; High-output heart failure; Point-of-care ultrasound; Venous congestion; Venous excess ultrasound score.