The article is a supplementary material for a study on fluid responsiveness and venous congestion in patients with sepsis and respiratory failure.
The study aimed to assess fluid responsiveness and venous congestion using various clinical variables and ultrasound scores.
The study examined the prevalence of venous congestion signals in mechanically ventilated patients with acute circulatory dysfunction within 24 hours of ICU admission.
The prevalence of venous congestion signals was high and independent of fluid responsiveness status.
There was no association between fluid balance or diagnosis and the presence of venous congestion signals.
More than half of the fluid responsive patients in the study could be considered potentially fluid intolerant as they had at least one venous congestion signal.
This subset of patients had higher odds of developing acute kidney injury at seven days.
The study suggests that clinicians should be aware of the potential dangers of fluid administration even in fluid responsive patients.
The study used different techniques to assess venous congestion, including central venous pressure, lung ultrasound score, and venous excess ultrasound score.
Lateral E/e’ and lung ultrasound score were used as surrogates for ventricular filling pressures and showed correlations with venous congestion signals.
The high prevalence of venous congestion in fluid responsive patients at ICU admission is a paradox that requires further investigation.
The study calls for future research to assess the evolution of fluid responsiveness and venous congestion throughout the resuscitation process in high-risk contexts.
Integration of these concepts into resuscitation algorithms could provide new tools for personalized resuscitation and avoid adverse events.
https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04834-1