Advances in Critical Care Pediatric Nephrology: Point of Care Ultrasound and Diagnostics

Description

The book covers advances in critical care pediatric nephrology, including care of sick children with acute kidney injury. The book contains detailed guidance on point of care ultrasound in children with acute kidney injury and use of biomarkers in critically sick children. This is an annual theme-based book with the current theme of 'point of care ultrasound in critical care pediatric nephrology and newer diagnostics in acute kidney injury'. This is the first book of the set of books to be published annually with a different theme related to critical care pediatric nephrology each year with the collaboration of the Pediatric Continous Renal Replacement Therapy (PCRRT) Foundation and International Collaboration of Nephrologists & Intensivists for Critical Care in Children (ICONIC). This annual updates book contains 20 chapters, written and edited by leading experts in pediatric intensive care, pediatric nephrology and nephrologists specializing in point of care ultrasound from across the globe. It includes top studies in the last few years in critical care pediatric nephrology on point of care ultrasound and diagnostics. Chapters cover scientifically updated information by international experts on each topic. It offers assistance to pediatricians, pediatric nephrologists, pediatric intensivists and residents. Preface Contents About the Editors Part I: Point of Care Ultrasound 1: Need for Point of Care Ultrasound in Critical Care Pediatric Nephrology 1.1 Advantages of POCUS 1.2 Disadvantages of POCUS 1.3 Main Applications in Critical Care Pediatric Nephrology References 2: Modes and Equipment 2.1 Introduction 2.2 Physics of Ultrasound 2.3 Ultrasound Jelly or Gel 2.4 Interactions of Ultrasound with Tissues 2.5 Equipment–Machine and Transducers 2.6 Image Orientation and Transducer/Probe Position 2.7 Modes 2.8 What Is Echogenicity? 2.9 How to Conduct an Ultrasound Examination of a Child? 2.10 Technique 2.11 Conclusion References 3: Sonography of the Kidneys in Children: Basics 3.1 Fetal Genitourinary Tract 3.1.1 Peculiarities in Renal Sonography in Neonates and Infants 3.2 Congenital Anatomical Variants 3.3 Bladder Outlet Obstruction 3.4 Cystic Renal Disease 3.4.1 Multicystic Dysplastic Kidney 3.4.2 Autosomal Dominant Polycystic Kidney Disease [ADPKD] 3.4.3 Autosomal Recessive Polycystic Kidney Disease [ARPKD] 3.4.4 Nephronophthisis 3.5 Renal Stone Disease and Nephrocalcinosis 3.5.1 Renal Stone Disease 3.5.2 Nephrocalcinosis 3.6 Antenatal and Postnatal Hydronephrosis 3.6.1 Antenatal Hydronephrosis 3.6.2 Postnatal Assessment of Antenatally Diagnosed Hydronephrosis 3.7 Vascular Anomalies 3.7.1 Renovascular Hypertension 3.7.2 Renal Vein Thrombosis [RVT] 3.7.3 Arteriovenous Malformation and Fistula 3.7.4 Nutcracker Syndrome 3.8 Acute Kidney Injury [AKI] 3.9 Chronic Kidney Disease [CKD] 3.10 Transplantation 3.11 Conclusion 4: Ultrasound Guided Procedures in PICU 4.1 CVCs Insertion Under Ultrasound Guidance 4.1.1 Ultrasound Machine 4.1.2 Ultrasound Views 4.1.3 Probes Selection 4.1.4 Procedure 4.1.5 The Common Approaches to CVCs by US Guidance 4.2 Kidney Biopsy Under Ultrasound Guidance 4.2.1 Indications for Renal Biopsy 4.2.2 Contraindication for Renal Biopsy 4.2.3 Biopsy Needles 4.2.4 Procedure 4.2.5 Complications 4.3 Suprapubic Aspiration Under Guidance of Ultrasound References 5: Lung and Cardiac Ultrasound for Assessment of Intravascular Volume Status in Children 5.1 Introduction 5.2 Lung Ultrasound 5.3 Technique 5.4 Interpretation 5.5 Focused Cardiac Ultrasound 5.6 Effusion 5.7 Ejection 5.8 Equality 5.9 Entrance 5.10 Exit 5.11 Summary and Clinical Integration References 6: Use of Point of Care Ultrasound in Access for Dialysis: Hemodialysis and Peritoneal Dialysis 6.1 Introduction 6.2 Role of Ultrasound (US) for Hemodialysis Vascular Access 6.2.1 Central Venous Catheter (CVC) Insertion: US-Guided Needle Placement 6.2.2 AV Access 6.3 Role of Ultrasound (US) in Peritoneal Dialysis Catheter Placement 6.3.1 Assessment of Abdominal Wall Thickness 6.3.2 Assessment of Blood Vessels 6.3.3 Assessment of Intra-Abdominal Adhesions 6.3.4 Assessment of the Urinary Bladder References 7: Focused Echocardiogram: A Case Based Approach 7.1 Clinical Scenario 7.1.1 Case 1 7.1.2 Case 2 7.2 Focused Echocardiogram 7.3 Basic Requirements for Focused Echocardiogram 7.4 The Applicability of FOCUS in Critically Ill Patients 7.4.1 Left Ventricular Systolic Dysfunction 7.4.2 Pericardial Effusion (PEff) 7.4.3 Pulmonary Edema (PE) References 8: Focused Cardiac Ultrasound (FOCUS) in Pediatric Intensive Care 8.1 Introduction 8.2 Technique 8.2.1 Transducer Choice and Preset 8.2.2 Patient Preparation 8.3 Transducer Orientation and Cardiac Views 8.3.1 Parasternal Long-Axis View 8.3.2 Parasternal Short-Axis View 8.3.3 Apical Four-Chamber View 8.3.4 Subxiphoid View 8.3.5 Inferior Vena Cava View 8.4 Pathology Identified Through Focused Echocardiogram 8.4.1 Cardiac Function 8.4.2 Cardiac Asystole 8.4.3 Pericardial Effusion and Tamponade 8.4.4 Pericardiocentesis 8.4.5 Hydration Status 8.5 FOCUS Limitations in the Pediatric ICU 8.6 Conclusion References 9: Need for Point of Care Ultrasonography Training and Certification in Pediatric Nephrology 9.1 Introduction 9.2 Scope of Practice 9.3 Training 9.4 Competency Assessment and Learner Feedback 9.5 Procuring Ultrasound Machine and Logistics References Part II: Newer Biomarkers in Acute Kidney Injury 10: Fluid Overload and Kidney Injury Score 10.1 Introduction 10.2 AKI Current Definitions and Limitations 10.3 Fluid Overload: Definitions and Clinical Significance 10.4 Early Intervention Strategies to Prevent AKI and Fluid Overload 10.5 Nephrotoxic Injury Negated by Just-in-Time Action 10.6 Renal Angina Index 10.7 Fluid Overload and Kidney Injury Score 10.8 Limitations of FOKIS 10.9 Conclusion References 11: Renal Oximetry in Neonates and Children During Cardiac Surgery 11.1 Some Practical Considerations 11.2 Baseline Renal NIRS Measurements and Influential Perioperative Factors 11.3 Acute Kidney Injury and Renal NIRS 11.4 Perioperative Renal Monitoring References 12: Defining Acute Kidney Injury in Children 12.1 Introduction 12.2 Metrics of Renal Injury, Function, and Dysfunction 12.2.1 Serum Creatinine 12.2.2 Urine Output 12.2.3 Glomerular Filtration Rate 12.2.4 Urinary AKI Biomarkers 12.3 Defining Acute Kidney Injury 12.3.1 Risk, Injury, Failure, Loss, ESRD (RIFLE) Criteria 12.3.2 Pediatric RIFLE (pRIFLE) Criteria 12.3.3 Acute Kidney Injury Network Criteria 12.3.4 Kidney Disease: Improving Global Outcomes 12.4 Summary References 13: Genetic Influences on Pediatric AKI 13.1 Introduction 13.2 Clinical Context 13.3 Genetic Study Approaches 13.4 AKI Heterogenicity and Genetics 13.5 Systematic Review 13.6 Conclusions References 14: New Markers of Acute Kidney Injury in Children Undergoing Hematopoietic Stem Cell Transplantation 14.1 Introduction 14.2 New Understanding of AKI 14.3 Serum Markers of Function 14.3.1 Cystatin C 14.4 Urinary Markers of Damage 14.4.1 Neutrophil Gelatinase-Associated Lipocalin 14.4.2 Kidney Injury Molecule (KIM)-1 14.4.3 Interleukin (IL)-18 14.4.4 Liver-Type Fatty Acid-Binding Protein 14.4.5 Reference Ranges of Damage Markers in Children 14.5 New Perspectives 14.5.1 Insulin-Like Growth Factor-Binding Protein-7 14.5.2 Tissue Inhibitor of Metalloproteinase-2 14.6 Practical Approach 14.7 Conclusions References 15: Limitations of Glomerular Filtration Rate Estimation in Pediatric Acute Kidney Injury 15.1 Introduction 15.1.1 Renal Function in the Growing Child 15.1.2 The Importance of Correct Drug Dosing in the Setting of Developmental Changes and Acute Kidney Injury 15.1.3 Inaccuracies of Predicting Vancomycin Clearance in the Acute Kidney Injury Setting, Both in the Neonates and Older Children 15.2 Renal Elimination of Drugs 15.3 Renal Drug Clearance in the Growing Child 15.3.1 Why GFR Does Not Necessarily Predict Renal Drug Clearance 15.4 Gold Standard of Measuring GFR and Effective Renal Plasma Flow (ERPF) 15.4.1 Clearance 15.4.2 Inulin Clearance 15.4.3 Autoregulation 15.4.4 Effective Renal Plasma Flow 15.5 Current Approach to Estimation of GFR 15.6 Novel Approaches 15.7 Conclusions 15.8 Practical Advice 15.9 Key Points References 16: Applied Metabolomics and Emerging Biomarkers in Neonatal Acute Kidney Injury 16.1 Introduction 16.2 Metabolomics 16.3 Biomarkers 16.3.1 NGAL 16.3.2 Cystatin C 16.3.3 KIM-1 16.3.4 IL-18 16.3.5 Netrin-1 16.4 Summary References 17: CKD Management Post-AKI: The Role of Biomarkers 17.1 The Basics 17.2 Current Diagnostic Criteria for AKI 17.3 Current Diagnostic Criteria for CKD 17.4 Progression from AKI to CKD 17.5 Biomarkers for AKI and Progression to CKD 17.5.1 Cystatin C 17.5.2 Neutrophil Gelatinase-Associated Lipocalin (NGAL) 17.5.3 Liver-Type Fatty Acid Binding Protein (L-FABP) 17.5.4 Kidney Injury Molecule-1 (KIM1) 17.5.5 Soluble Urokinase Plasminogen Activator Receptor (suPAR) 17.5.6 IL-18 17.5.7 FGF23 and Endothelium Biomarkers 17.6 Biomarkers for AKI Without Current Studies Evaluating Their Role in CKD Progression 17.6.1 Tissue Inhibitor of Metalloproteinases-2 (TIMP-2) and Insulin-Like Growth Factor-Binding Protein-7 (IGFBP7) 17.6.2 Renal Resistive Index (RRI) 17.7 Future Directions References 18: Functional Renal Reserve and Furosemide Stress Test 18.1 Introduction 18.2 Glomerular Filtration Rate (GFR) and Concept of Functional Renal Reserve 18.3 Oral Protein Intake Increases GFR: The Protein Tolerance Test 18.4 The Stress GFR (or the Glomerular Stress Test) and the Tubular Stress Test 18.4.1 Tubular Stress Test 18.4.2 Utility of Stress Testing 18.5 Renal Functional Reserve as Biomarker 18.6 Renal Functional Reserve in AKI and CKD 18.7 Furosemide Stress Test: Physiology and Pharmacology of Loop Diuretics 18.7.1 Caveats with FST 18.8 Current Evidence on FST 18.9 Conclusions References 19: Up-to-Date Systematic Approach to the Spectrum of Thrombotic Microangiopathy 19.1 Introduction 19.2 Classifications 19.3 Pathophysiology 19.3.1 TMA Caused by STEC-HUS 19.3.2 TMA Caused by Complement Dysregulation 19.3.3 Thrombotic Thrombocytopenic Purpura 19.4 Clinical Manifestation 19.5 Diagnosis 19.6 Treatment 19.6.1 General Measures 19.6.2 Specific Therapeutic Measures References