# The Role of Portal Vein Pulsatility and Point-of-Care Ultrasound (POCUS) to Guide Decongestion and Hemodynamic Management in Acute Leptospirosis

**Authors:** Keevan Singh, Kevin Singh, Laken Boochoon

PMC · DOI: 10.7759/cureus.87055 · Cureus · 2025-06-30

## TL;DR

This paper explores how portal vein pulsatility and point-of-care ultrasound can help manage heart and kidney issues in acute leptospirosis patients.

## Contribution

The study introduces portal vein pulsatility as a novel POCUS parameter for assessing and guiding decongestion in leptospirosis.

## Key findings

- Portal vein pulsatility provides insights into end-organ congestion in leptospirosis.
- POCUS can guide hemodynamic therapy in patients with cardiac and renal failure due to leptospirosis.

## Abstract

Leptospirosis is a relatively common tropical disease that can present with multiorgan failure. Given its wide range of phenotypes, leptospirosis patients presenting with cardiac and renal failure may benefit from diuresis and decongestion. Estimating left atrial pressure and its surrogates, point-of-care ultrasound (POCUS) can help guide decongestive and hemodynamic therapy in these patients. A novel component of POCUS assessment, portal vein pulsatility, can provide information on end-organ congestion and aid in the titration of hemodynamic interventions.

## Linked entities

- **Diseases:** leptospirosis (MONDO:0005825)

## Full-text entities

- **Diseases:** critically ill (MESH:D016638), pulmonary, renal, and cardiac dysfunction (MESH:C538458), diarrhea (MESH:D003967), venous congestion (MESH:D006940), myocardial strain (MESH:D013180), sinus tachycardia (MESH:D013616), hyperkalemia (MESH:D006947), biventricular systolic dysfunction (MESH:D018487), cardiac and renal failure (MESH:D006333), Leptospirosis (MESH:D007922), shortness of breath (MESH:D004417), organ dysfunction (MESH:D009102), pulmonary congestion (MESH:D001261), septic shock (MESH:D012772), prolonged QT interval (MESH:D008133), Tropical diseases (MESH:D015493), Organ congestion (MESH:D000092124), pulsatile portal vein (MESH:D014012), cardiogenic shock (MESH:D012770), shock (MESH:D012769), myocardial involvement (MESH:C564676), pulmonary edema (MESH:D011654), sepsis (MESH:D018805), end (MESH:D003643), infectious disease (MESH:D003141), myocarditis (MESH:D009205), low cardiac output (MESH:D002303), multiorgan failure (MESH:D051437), hypotensive (MESH:D007022), stroke (MESH:D020521), Fluid loss (MESH:D002559), edema (MESH:D004487), acute kidney injury (MESH:D058186), vomiting (MESH:D014839), congestion (MESH:D002311), biventricular dysfunction (MESH:D018754), cardiac arrest (MESH:D006323), fever (MESH:D005334)
- **Chemicals:** noradrenaline (MESH:D009638), creatinine (MESH:D003404), vasoactive medication (-), Furosemide (MESH:D005665), potassium (MESH:D011188), sodium bicarbonate (MESH:D017693), oxygen (MESH:D010100), adrenaline (MESH:D004837), carbon dioxide (MESH:D002245), Ceftriaxone (MESH:D002443), propofol (MESH:D015742), lactate (MESH:D019344)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12310407/full.md

## References

24 references — full list in the complete paper: https://tomesphere.com/paper/PMC12310407/full.md

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Source: https://tomesphere.com/paper/PMC12310407