Coexistence of a fuid responsive state and venous congestion signals in critically ill patients: a multicenter observational proof-of-concept study

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dc.article.number52
dc.catalogadorpva
dc.contributor.authorMuñoz, Felipe
dc.contributor.authorBorn, Pablo
dc.contributor.authorBruna, Mario
dc.contributor.authorUlloa, Rodrigo
dc.contributor.authorGonzalez Almonacid, Cecilia Ignacia
dc.contributor.authorPhilp Sandoval, Valerie Rose
dc.contributor.authorMondaca Pavie, Roberto Francisco     
dc.contributor.authorBlanco Guerrero, Juan Pablo
dc.contributor.authorValenzuela Espinoza, Emilio Daniel
dc.contributor.authorRetamal Montes, Jaime
dc.contributor.authorMiralles, Francisco
dc.contributor.authorWendel-Garcia, Pedro D.
dc.contributor.authorOspina-Tascón, Gustavo A.
dc.contributor.authorCastro Lopez, Ricardo Adolfo
dc.contributor.authorRola, Philippe
dc.contributor.authorBakker, Jan
dc.contributor.authorHernández P., Glenn
dc.contributor.authorKattan Tala, Eduardo José
dc.date.accessioned2024-03-07T18:53:08Z
dc.date.available2024-03-07T18:53:08Z
dc.date.issued2024
dc.date.updated2024-02-25T01:03:44Z
dc.description.abstractBackground: Current recommendations support guiding fluid resuscitation through the assessment of fluid responsiveness. Recently, the concept of fluid tolerance and the prevention of venous congestion (VC) have emerged as relevant aspects to be considered to avoid potentially deleterious side effects of fluid resuscitation. However, there is paucity of data on the relationship of fluid responsiveness and VC. This study aims to compare the prevalence of venous congestion in fluid responsive and fluid unresponsive critically ill patients after intensive care (ICU) admission. Methods: Multicenter, prospective cross-sectional observational study conducted in three medical–surgical ICUs in Chile. Consecutive mechanically ventilated patients that required vasopressors and admitted < 24 h to ICU were included between November 2022 and June 2023. Patients were assessed simultaneously for fluid responsiveness and VC at a single timepoint. Fluid responsiveness status, VC signals such as central venous pressure, estimation of left ventricular filling pressures, lung, and abdominal ultrasound congestion indexes and relevant clinical data were collected. Results: Ninety patients were included. Median age was 63 [45–71] years old, and median SOFA score was 9 [7–11]. Thirty-eight percent of the patients were fluid responsive (FR+), while 62% were fluid unresponsive (FR−). The most prevalent diagnosis was sepsis (41%) followed by respiratory failure (22%). The prevalence of at least one VC signal was not significantly different between FR+ and FR− groups (53% vs. 57%, p = 0.69), as well as the proportion of patients with 2 or 3 VC signals (15% vs. 21%, p = 0.4). We found no association between fluid balance, CRT status, or diagnostic group and the presence of VC signals. Conclusions: Venous congestion signals were prevalent in both fluid responsive and unresponsive critically ill patients. The presence of venous congestion was not associated with fluid balance or diagnostic group. Further studies should assess the clinical relevance of these results and their potential impact on resuscitation and monitoring practices.
dc.fechaingreso.objetodigital2024-02-25
dc.fuente.origenAutoarchivo
dc.identifier.citationCritical Care. 2024 Feb 19;28(1):52
dc.identifier.doi10.1186/s13054-024-04834-1
dc.identifier.urihttps://doi.org/10.1186/s13054-024-04834-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/84288
dc.identifier.wosidWOS:001174707800002
dc.information.autorucEscuela de Medicina; Born, Pablo; S/I; 223841
dc.information.autorucEscuela de Medicina; Gonzalez Almonacid, Cecilia Ignacia; S/I; 247611
dc.information.autorucEscuela de Medicina; Philp Sandoval, Valerie Rose; S/I; 1159394
dc.information.autorucEscuela de Medicina; Mondaca Pavie, Roberto Francisco     ; S/I; 1102882
dc.information.autorucEscuela de Medicina; Blanco Guerrero, Juan Pablo; S/I; 1143499
dc.information.autorucEscuela de Medicina; Valenzuela Espinoza, Emilio Daniel; 0000-0001-9758-3473; 1056714
dc.information.autorucEscuela de Medicina; Retamal Montes, Jaime; 0000-0002-6817-3659; 175147
dc.information.autorucEscuela de Medicina; Castro Lopez, Ricardo Adolfo; 0000-0002-0978-9891; 4537
dc.information.autorucEscuela de Medicina; Bakker, Jan; 0000-0003-2236-7391; 1044227
dc.information.autorucEscuela de Medicina; Hernández P., Glenn; 0000-0002-3032-4087; 98874
dc.information.autorucEscuela de Medicina; Kattan Tala, Eduardo José; 0000-0002-1997-6893; 172152
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final10
dc.pagina.inicio1
dc.revistaCritical Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseCreative Commons Attribution 4.0 International License
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectFluid resuscitation
dc.subjectVenous congestion
dc.subjectFluid responsiveness
dc.subjectCritical care
dc.subjectVExUS
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCoexistence of a fuid responsive state and venous congestion signals in critically ill patients: a multicenter observational proof-of-concept study
dc.typeartículo
dc.volumen28
sipa.codpersvinculados223841
sipa.codpersvinculados247611
sipa.codpersvinculados1159394
sipa.codpersvinculados1102882
sipa.codpersvinculados1143499
sipa.codpersvinculados1056714
sipa.codpersvinculados175147
sipa.codpersvinculados4537
sipa.codpersvinculados1044227
sipa.codpersvinculados98874
sipa.codpersvinculados172152
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