As the coronavirus disease 2019 (COVID-19) continues to spread across the globe, the knowledge of its epidemiology, clinical features, and management is rapidly evolving. Nevertheless, the data on optimal fluid management strategies for those who develop critical illness remain sparse. Adding to the challenge, the fluid volume status of these patients has been found to be dynamic. Some present with several days of malaise, gastrointestinal symptoms, and consequent hypovolemia requiring aggressive fluid resuscitation, while a subset develop acute respiratory distress syndrome with renal dysfunction and lingering congestion necessitating restrictive fluid management. Accurate objective assessment of volume status allows physicians to tailor the fluid management goals throughout this wide spectrum of critical illness. Conventional point-of-care ultrasonography (POCUS) enables the reliable assessment of fluid status and reducing the staff exposure. However, due to specific characteristics of COVID-19 (e.g., rapidly expanding lung lesions), a single imaging method such as lung POCUS will have significant limitations. Herein, we suggest a Tri-POCUS approach that represents concurrent bedside assessment of the lungs, heart, and the venous system. This combinational approach is likely to overcome the limitations of the individual methods and provide a more precise evaluation of the volume status in critically ill patients with COVID-19.
Cardiorenal Med

中文翻译：

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需要客观评估 COVID-19 危重患者的容量状态：Tri-POCUS 方法。


随着 2019 年冠状病毒病 (COVID-19) 继续在全球传播，有关其流行病学、临床特征和管理的知识正在迅速发展。然而，关于患有危重疾病的患者的最佳液体管理策略的数据仍然很少。更困难的是，这些患者的体液容量状态是动态的。有些患者会出现数天的不适、胃肠道症状以及随之而来的血容量不足，需要积极的液体复苏，而一部分患者会出现急性呼吸窘迫综合征，伴有肾功能障碍和持续充血，需要限制液体管理。对容量状态的准确客观评估使医生能够针对各种危重疾病定制液体管理目标。传统的护理点超声检查 (POCUS) 能够可靠地评估液体状态并减少工作人员的暴露。然而，由于COVID-19的具体特征（例如，肺部病变迅速扩大），诸如肺部POCUS之类的单一成像方法将具有显着的局限性。在此，我们建议采用 Tri-POCUS 方法，该方法代表对肺、心脏和静脉系统的同步床边评估。这种组合方法可能会克服各个方法的局限性，并对 COVID-19 危重患者的容量状态提供更精确的评估。
 心肾医学