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Feasibility and early experience with venous Doppler congestion assessment in post-operative lung transplant patients

Background

The role of venous Doppler ultrasound in assessing venous congestion in the setting of post-lung transplantation surgery is unknown.

We performed a feasibility study on the use of venous Doppler ultrasound in the immediate post-operative period after lung transplantation in a retrospective, single-center observational evaluation.

Patients had at least two venous congestion Doppler ultrasound exams involving interrogation of IVC diameter, hepatic vein, portal vein and renal vein Doppler assessments.

Results

A total of 9 patients were included in our study with a median age of 60 years, 66.7% being male, and a median BMI of 20.9.

All patients had VExUS grade ≥1 on their first venous Doppler exam. All nine patients had a decrease in portal vein pulsatility from initial to final exams. Correlation between portal venous pulsatility and net fluid balance was not statistically significant R= 0.33 (P= 0.39).

Other parameters, including VExUS grade, IVC diameter, HV and RV Doppler changes from initial to final ultrasound exams showed variable changes in the post-operative period.

Conclusions

Venous congestion Doppler ultrasound assessments appear feasible in immediate postoperative lung transplant patients.

A multitude of factors beyond fluid status likely affect waveforms.

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