Worsening SOB while on dialysis
A 46yo female presented with worsening SOB over 2 weeks. She had decreased exercise tolerance and difficulty sleeping which was becoming progressively worse. No cough, chest pain or fevers. She had had a viral illness 3 weeks ago but had no residual Sx from this.
PHx nightly peritoneal dialysis for the last 3 years post GN renal failure. This has been going well. nil issues, nil abdo pain. HT on usual meds, nil recent change.
On Ex HR 100, sats 100% on air, BP 110/60, afebrile. She had fine crackles bibasally and normal HS, no calf swelling or peripheral oedema. Abdomen soft and NT.
This is her CXR
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The CXR was interpreted as overloaded and the patient was referred to renal for fluid overload ? inadequate dialysis.
What ultrasound would you like to do at the bedside to clarify this?
What further investigations would you like to order?