# Sonographic findings using the SAFE-A protocol in pre- and post-hemodialysis patients

## TL;DR

This study shows that a sonographic protocol called SAFE-A can estimate fluid changes in patients undergoing hemodialysis.

## Contribution

The study confirms the SAFE-A protocol's effectiveness in hemodialysis patients by correlating sonographic scores with fluid removal.

## Key findings

- A 1-point decrease in SAFE-A score correlates with 426.73 mL of net ultrafiltrate removal.
- The SAFE-A protocol score strongly correlates with intravascular volume status in hemodialysis patients.
- Findings align with prior studies in different populations, validating the protocol's utility.

## Abstract

Accurate assessment of relative intravascular volume is one of the cornerstones for the proper management of hospitalized patients requiring hemodialysis. Currently, the use of dynamic parameters such as bedside ultrasonography is recommended to support the assessment of the intravascular volume profile. This study aimed to prospectively evaluate findings of sonographic assessment of intravascular volume estimate (SAFE-A) protocol among hemodialysis inpatients with end-stage renal disease, before and after the hemodialysis sessions, and correlate these findings with the net ultrafiltrate (UFNET).

A positive correlation was found between the negative variation of 1 point in the score of the SAFE-A protocol with the withdrawal of 426.73 mL of net ultrafiltrate.

There was a strong correlation between the score of the SAFE-A protocol and the net ultrafiltrate. Therefore, this study concludes that the application of the SAFE-A protocol in dialysis patients demonstrates a correlation between the suggested score and volume status, consistent with findings from the original study conducted in a distinct population.