Dynamic Assessment of Fluid Responsiveness and Venous Congestion: Evolution of the VExUS Score During Volume Expansion
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Bicetre Hospital
- Enrollment
- 64
- Locations
- 3
- Primary Endpoint
- The difference in venous congestion (VExUS) changes between fluid responders and non-responders following a fluid challenge.
Overview
Brief Summary
Fluid responsiveness is a critical determinant guiding fluid therapy in critically ill patients. However, excessive fluid administration can result in fluid overload, leading to venous congestion and worse clinical outcomes. Venous congestion, a marker of impaired fluid clearance, is increasingly recognized as a significant contributor to poor prognosis. Previous studies have demonstrated the coexistence of fluid responsiveness and venous congestion in critically ill patients. Notably, these studies were limited by the absence of fluid challenge-the gold standard for assessing fluid responsiveness-leaving the dynamic relationship between fluid responsiveness and venous congestion incompletely understood. This study aims to investigate the interplay and temporal evolution of fluid responsiveness and venous congestion following a standardized fluid challenge in critically ill patients.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to 99 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥ 18 years
- •Hospitalized in the intensive care unit (ICU)
- •Hemodynamic monitoring in place, with a pulse wave contour analysis- derived estimation of cardiac output (either calibrated or uncalibrated)
- •Decision made by clinicians to perform volume expansion through intravenous infusion of crystalloid fluid
Exclusion Criteria
- •Pregnancy
- •Refusal to participate by relatives of the patient or the patient himself
Outcomes
Primary Outcomes
The difference in venous congestion (VExUS) changes between fluid responders and non-responders following a fluid challenge.
Time Frame: before and after 15-minute fluid challenge.
Secondary Outcomes
- The differential evolution of venous congestion (VExUS) changes between fluid responders and non-responders 1 hour after a fluid challenge.(1 hour after fluid challenge)
Investigators
Xavier Monnet
Professor Xavier Monnet, MD, PHD
Bicetre Hospital