Adjuvant techniques to enhance the history and physical in assessing hypervolemia

What are some adjuvant techniques to enhance the history and physical in assessing hypervolemia?

Given the association of volume overload with excess mortality and readmissions in heart failure and kidney disease, a variety of methods have been developed for noninvasively assessing volume overload. These methods take advantage of changes in physical properties as ECF volume increases. As with the history and physical exam, each method has limitations and their utility may be in the aggregate. This chapter will look at the noninvasive techniques with availability in inpatient or outpatient settings that have the best validation and most clinical utility:

• Bioimpedance spectroscopy (BIS)

• Lung-water ultrasound

• Intradialytic blood volume monitoring (BVM) devices

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