The Venous Excess Ultrasound (VExUS) grading to predict tolerance to fluid de-escalation in critically ill patients
- Conditions
- Critically ill patientsCirculatory shockFluid de-escalationVExUSFluid de-escalationFluid removalTolerance
Recruitment & Eligibility
- Status
- Pending (Not yet recruiting)
- Sex
- All
- Target Recruitment
- 65
1.Adult patients (age 18 years and over) admitted in intensive care units (both medical and surgical ICU) of Ramathibodi Hospital
2.Presence of fluid accumulation, defined as positive fluid balance 10% or more of body weight
3.Hemodynamic stability, defined as
a. Adequate tissue perfusion (capillary refilling time less than 3 seconds)
b. Mean arterial pressure more than 65 mmHg with
i.Clearing decreasing dose of vasopressor
ii.Norepinephrine less than 0.2 mcg/kg/min
iii.Arterial lactate level less than 2 mmol/L
4.Need for fluid de-escalation, as decided by the attending physicians
1.Patients who refused to participate in the study or withdraw from the study
2.Patients who had severe chronic kidney disease (estimated glomerular filtration rate less than 15 mL/min per 1.73 m2 or in regular dialysis program) or renal transplantation
3.Patients with obstacles to abdominal ultrasound include severe obesity (BMI of 40 or higher), having had abdominal surgery or having abdominal burn wounds in the positions that may impede ultrasound.
4.Patients with previously known conditions that interfere with portal Doppler assessments (liver cirrhosis, portal vein thrombosis, or severe tricuspid regurgitation with structural heart disease)
5.Pregnancy
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Ability of VExUS grading 6 and 24 hours after fluid de-escalation hypotension, AKI
- Secondary Outcome Measures
Name Time Method VExUS grade 6 and 24 hours after fluid de-escalation Change in grade of VExUS