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

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.