Abstract
To gain new insights into renal perfusion and pathogenesis of acute kidney injury in intensive care unit (ICU) patients, we need new techniques to evaluate renal microcirculation. In addition, a bedside technique applicable in the ICU could be extremely useful for physicians to adjust the optimal therapeutic/preventive modalities for kidney perfusion in each patient. Contrast-enhanced ultrasound (CEUS) has been validated to assess and quantify the microcirculation up to capillary perfusion in several organs. In a recent issue, Schneider and colleagues suggest that CEUS is feasible, well tolerated and able to quantify cortical renal microcirculation in patients undergoing cardiac surgery. In addition, CEUS derived-parameters suggest a decrease in renal perfusion occurring within 24 hours of surgery in patients at risk of acute kidney injury. This study opens up new possibilities for the assessment of cortical renal microcirculation in ICU patients.
Highlights
To gain new insights into renal perfusion and pathogenesis of acute kidney injury in intensive care unit (ICU) patients, we need new techniques to evaluate renal microcirculation
Schneider and colleagues [1] reported for the first time that contrastenhanced ultrasound (CEUS), a recent technique for quantification of tissue perfusion and microcirculation, is able to assess renal cortical perfusion in ICU patients before and after cardiac surgery
Contrast-enhanced ultrasound (CEUS) derived-parameters suggest a decrease in renal perfusion occurring within 24 hours of surgery in patients at risk of acute kidney injury (AKI)
Summary
To gain new insights into renal perfusion and pathogenesis of acute kidney injury in intensive care unit (ICU) patients, we need new techniques to evaluate renal microcirculation. The primary resuscitation strategy for these patients is to restore effective renal blood flow (RBF) by fluid resuscitation to maintain adequate renal microcirculation and parenchymal oxygen and thereby prevent AKI. To gain new insights into renal perfusion and pathogenesis of AKI in intensive care unit (ICU) patients, we need new techniques to evaluate RBF and kidney microcirculation.
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