<qa>  What is the standard of care for critically ill patients?Conventional management of acute oliguria in shock has been to blindly push fluids to improve renal perfusion or to give loop diuretics once fluid loading has been considered as accomplished. However both volume overload and blind attempts at fluid removal can worsen renal injury and have been associated with higher mortality by venous overcongestion 5 and inappropriate hypovolemia 6-8. It seems reasonable to assume that a bedside test to visualize volume status and renal perfusion may assist in improving outcomes in this cohort. Intensive care unit ICU bedside ultrasound has become the standard of care for critically ill patients9-18. In patients with shock, inferior vena cava ultrasonographic evaluation for fluid responsiveness is routinely used to direct resuscitation 19-21 by direct measurement of IVC diameter and respiratory variation or by the response to a noninvasive fluid bolus from a passive leg raise 22. Doppler ultrasound of intrarenal vessels has also been described as a tool to assess renal perfusion 23-27. 