‘Pump Pipes Leaks’ model of fluid status assessment by the nephrologist
Fluid status assessment is very complex and currently, there is no gold standard to do this at the bedside. Over-reliance on a single parameter, whether a an element of history (including weight), physical examination finding or a sonographic finding (such as IVC US) is error prone. Goal-directed sonographic assessment of the pump, pipes, and the leaks provides helpful insights into systemic hemodynamics that can be integrated with conventional assessment to guide treatment decisions in patients with tenuous volume status. The pump represents focused cardiac ultrasound (FoCUS), pipes represent inferior vena cava (IVC) ultrasound and venous Doppler, and the leaks indicate assessment of the extravascular lung and abdominal fluid. Click here to read our comprehensive review of this topic (open access).
Here is another review article of ours published in Kidney360: Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography.