Program Overview
Thursday & Friday, July 11 & 12, 2024
IN-PERSON, HANDS-ON PROGRAM
Advances in the use of ultrasonography enhance our ability to better characterize acute kidney injury (AKI) and volume assessment in critically ill patients. The initial approach to AKI differentiates between pre-renal, intrinsic, and post-renal/obstructive AKI. Pre-renal AKI results from decreased perfusion of the kidney parenchyma. Intrinsic AKI is an insult that progresses to damage of the kidney tubules and/or direct damage to the nephron itself. Post-renal AKI develops from blockage after the kidney collecting system, such as nephrolithiasis, malignancy compressing a ureter, or prostatic hypertrophy. Pre-renal and post-renal injuries can be reversible, but prolonged injury may develop into intrinsic AKI. The rapid diagnosis of pre- and post-renal obstruction can lead to reversal; ultrasonography through high quality imaging is therefore critical for clinical care, and identification of chronic kidney disease (CKD). Assessment of volume status is an essential component to the care of both the critically ill patient and the care of patient with heart and renal failure. Volume resuscitation management is guided by often inaccurate methods, leading to delays in care management decisions. While volume depletion and decreased cardiac output lead to end organ damage and increased morbidity and mortality, so too does fluid overload lead to pulmonary edema and respiratory failure, heart failure, AKI, hepatic congestion, tissue breakdown and impaired bowel function. POCUS offers additional methods of volume assessment through lung imaging to evaluate for interstitial edema and pleural effusions. A focused cardiac evaluation with POCUS can also be helpful for non-cardiologist physicians in identifying left ventricular dysfunction, valvular dysfunction and pericardial effusions. Point of Care Ultrasound (POCUS) enhances ability to characterize acute kidney injury and volume assessment in critically ill patients. Challenges to POCUS training for nephrologists include: relatively new use of POCUS, physicians lack POCUS training, and lack of POCUS in graduate medical education. Our objective is to train nephrologists utilizing a 2-day curriculum that satisfys POCUS certification through the American Society of Diagnostic and Interventional Nephrology.
Learning Objectives
1. Point of care Ultrasound targets acute kidney injury and volume assessment in critically ill patients through POCUS.
2. Identify and train nephrologists utilizing a 2-day curriculum that satisfies POCUS certification through the American Society of Diagnostic and Interventional Nephrology.
3. Discuss and train the uses of POCUS with physicians and graduate medical education students who lack POCUS training.