Prognostic Power of the VEXUS Score in Septic Shock: Efficacy in Mortality Prediction
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 100
- Primary Endpoint
- 28-day intensive care unit mortality in relation to VEXUS score
Study Overview
Brief Summary
This study aims to evaluate the prognostic power of the VEXUS Score in predicting mortality among patients with septic shock in intensive care units.
Detailed Description
After the diagnosis of septic shock, patients will be assessed for eligibility. Following informed consent, measurements will be taken within the first 4 hours of shock onset, and treatment (inotropic and vasopressor doses, fluid challenge, corticosteroids) will be recorded. A second measurement will occur between 12 and 24 hours, and a third at 72 hours. All treatment and care protocols will be managed according to routine unit protocols.
Data will be systematically collected at three time points (0-4 hours, 12-24 hours, and 72 hours). These will include hemodynamic parameters, laboratory tests (including infection markers), need for renal replacement therapy, mechanical ventilation requirement and duration, cumulative dose and duration of vasopressor use, ICU stay, and survival status.
VEXUS Score Grading
The VEXUS score will be graded as follows:
- Grade 0 (No Congestion): No signs of venous congestion are detected. The inferior vena cava (IVC) diameter is less than 2 cm.
- Grade 1 (Mild Venous Congestion): The IVC diameter is 2 cm or greater. However, hepatic, portal, or renal vein flow measurements exhibit normal waveform patterns, or only one mildly abnormal waveform pattern is present.
- Grade 2 (Moderate Venous Congestion): The IVC diameter is 2 cm or greater. Additionally, analysis of hepatic, portal, or renal vein waveforms reveals one severe congestion finding.
- Grade 3 (Severe Venous Congestion): The IVC diameter is 2 cm or greater. Furthermore, analysis of hepatic, portal, or renal vein waveforms shows two or more severe congestion findings.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients monitored for septic shock in intensive care unit
- •Signed informed consent
Exclusion Criteria
- •Severe obesity precluding adequate ultrasonographic imaging.
- •Patients in whom venous structures cannot be clearly assessed via ultrasonography due to anatomical or technical reasons (e.g., adhesions following abdominal surgery).
- •Patients receiving dialysis due to chronic kidney disease or initiating dialysis for acute kidney failure.
- •Chronic heart failure.
- •Patients with advanced valvular insufficiency or advanced pulmonary hypertension.
- •Patients with portal hypertension or advanced-stage liver cirrhosis.
- •Presence of acute or chronic thrombosis in the inferior vena cava or other venous structures within the scoring area.
- •Refusal to participate
Outcomes
Primary Outcomes
28-day intensive care unit mortality in relation to VEXUS score
Time Frame: Up to 28 days following intensive care unit admission.
Investigation of the relationship between VEXUS Score and 28-day mortality in patients diagnosed with septic shock in the intensive care unit.
Secondary Outcomes
- Need for mechanical ventilation in relation to VEXUS score(Within the first 72 hours of intensive care unit admission.)
- Duration of mechanical ventilation in relation to VEXUS score.(From intensive care unit patients admission until extubation, up to 28 days.)
- Length of intensive care unit stay in relation to VEXUS score(From intensive care unit admission until intensive care unit discharge, up to 28 days.)
- Vasopressor dose and duration in relation to VEXUS score.(First 72 hours after intensive care unit admission)
Investigators
Nilgun Kavrut Ozturk
Professor
Antalya Training and Research Hospital