Background: Lingering congestion portends poor outcomes in patients with heart failure (HF) and is a key target in their management. Studies have shown that physical exam has low yield in this setting and conventional methods for more precise assessment and monitoring of volume status (e.g., body weight, natriuretic peptides, and chest radiography) have significant inherent shortcomings. Summary: Point of care ultrasonography (POCUS) is a noninvasive versatile bedside diagnostic tool that enhances the sensitivity of conventional physical examination to gauge congestion in these patients. It also aids in monitoring the efficacy of decongestive therapy and bears prognostic significance. In this narrative review, we discuss the role of focused sonographic assessment of the heart, venous system, and extravascular lung water/ascites (i.e., the pump, pipes, and the leaks) in objective assessment of fluid volume status. Key Messages: Since each of the discussed components of POCUS has its limitations, a combinational ultrasound evaluation guided by the main clinical features would be the key to reliable assessment and effective management of congestion in patients with HF.
Cardiorenal Med

中文翻译：

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用于心力衰竭客观评估的床旁超声检查：整合心脏、血管和血管外容量状态的决定因素

背景：持续充血预示着心力衰竭 (HF) 患者的预后不佳，是其管理的关键目标。研究表明，体格检查在这种情况下效率低，用于更精确地评​​估和监测容量状态（例如体重、利钠肽和胸片）的传统方法具有显着的固有缺陷。概括：床旁超声检查 (POCUS) 是一种无创的多功能床边诊断工具，可提高常规体检的敏感性，以衡量这些患者的充血情况。它还有助于监测减充血疗法的疗效并具有预后意义。在这篇叙述性综述中，我们讨论了心脏、静脉系统和血管外肺水/腹水（即泵、管道和渗漏）的聚焦超声评估在客观评估液体容量状态中的作用。关键信息：由于所讨论的 POCUS 的每个组成部分都有其局限性，以主要临床特征为指导的组合超声评估将是可靠评估和有效管理 HF 患者充血的关键。
心肾医学