Detection of pulmonary congestion by chest ultrasound in dialysis patients

OBJECTIVES: This study sought to investigate clinical and echocardiographic correlates of the lung comets score. BACKGROUND: Early detection of pulmonary congestion is a fundamental goal for the prevention of congestive heart failure in high-risk patients. METHODS: We undertook an inclusive survey by a validated ultrasound (US) technique in a hemodialysis center to estimate the prevalence of pulmonary congestion and its reversibility after dialysis in a population of 75 hemodialysis patients. RESULTS: Chest US examinations were successfully completed in all patients (N = 75). Before dialysis, 47 patients (63%) exhibited moderate to severe lung congestion. This alteration was commonly observed in patients with heart failure but also in the majority of asymptomatic (32 of 56, 57%) and normohydrated (19 of 38, 50%) patients. Lung water excess was unrelated with hydration status but it was strongly associated with New York Heart Association functional class (p 0.0001), left ventricular ejection fraction (r