Ultrasound Markers of Organ Congestion in Severe Acute Kidney Injury

Background: Fluid overload is associated with adverse outcomes in patients with severe acute kidney injury. It remains unclear if fluid overload is merely a marker of disease severity or if organ congestion is a direct mediator of complications. Point-of-care ultrasound could be a modality used to assess organ congestion and its clinical implications. Objective: To determine whether ultrasound markers of organ congestions are associated with major adverse kidney events and other adverse clinical outcomes. Study design: A cohort of critically ill patients with a new onset of severe acute kidney injury will undergo repeated ultrasound assessments to detect the presence of the following markers: * Portal flow pulsatility on pulse-wave Doppler * Discontinuous intra-renal venous flow on pulse-wave Doppler * Abnormal hepatic vein waveform on pulse wave Doppler * Presence of pulmonary B-line artifacts on 2D lung ultrasound * Presence of dilated and non-collapsible inferior vena cava on 2D ultrasound * Presence of systolic right ventricular dysfunction * Presence of systolic left ventricular dysfunction Clinical outcomes will be collected for up to 90 days after recruitment. Perspective: An approach targeting the resolution of organ congestion might improve the prognosis in patients with severe acute kidney injury. Identifying clinically relevant markers of organ congestion is a precursor to the design of future interventional trials investigating personalized fluid balance management.