Work

#107 - Point-of-care Ultrasound (pocus) Assessment in Patients With Decompensated Cirrhosis Receiving Albumin Therapy

Year: 2026

Type: article

Abstract: Introduction and Objectives Patients with cirrhosis and ascites are at risk of both intravascular depletion and fluid overload, while clinical volume assessment remains inaccurate. Point-of-care ultrasound (POCUS) may improve characterization of volume status through evaluation of venous congestion and intravascular filling.To describe intravascular volume status assessed by multiorgan POCUS in patients with decompensated cirrhosis receiving intravenous albumin for AKI. Materials and Methods We conducted a case series including patients aged 18–65 years with cirrhosis and stage 1B AKI requiring intravenous albumin. Multiorgan POCUS was performed before albumin administration and at 24 and 48 hours, including lung ultrasound, internal jugular vein (IJV) collapsibility, inferior vena cava assessment, and abdominal venous Doppler evaluation. Congestion was defined by 1 abnormal finding suggestive of pulmonary or venous congestion. Renal function, development of HRS-AKI, mortality, and albumin-related adverse events were recorded. Results Nine patients with predominantly Child-Pugh C cirrhosis and a mean MELD score of 24.1 were included. At baseline, five patients demonstrated reduced IJV collapsibility suggestive of venous congestion; however, none showed pulmonary congestion or severe abdominal Doppler abnormalities. All patients received intravenous albumin. Reduced IJV collapsibility persisted in some patients during serial evaluations, without pulmonary or severe Doppler congestion. Following albumin therapy, AKI resolved in five patients and serum creatinine improved in two additional patients. One patient developed HRS-AKI and one died. No albumin-related adverse events were reported. Conclusions Despite evidence of venous congestion in several patients, most experienced renal improvement following albumin administration. These findings support the potential role of multiorgan POCUS for individualized volume assessment in decompensated cirrhosis

Source: Annals of Hepatology

DOI: 10.1016/j.aohep.2026.102367