Observational studyCritical care (London, England)2024
Coexistence of a fluid responsive state and venous congestion signals in critically ill patients: a multicenter observational proof-of-concept study.
Observational study in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Fluid Intolerance Signals as Safety Limits to Prevent Fluid-induced Harm During Septic Shock Resuscitation
Dynamic Assessment of Fluid Responsiveness and Venous Congestion: Evolution of the VExUS Score During Volume Expansion
The Impact of VeXUS-guided Fluid Management in ICU Populations on Renal Function
VEXUS-REA : Evaluation of Ultrasound Parameters of Venous Congestion in Patients in a Medical Intensive Care Unit
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Dynamic Measures of Fluid Responsiveness to Guide Resuscitation in Patients With Sepsis and Septic Shock: A Systematic Review and Meta-Analysis.Critical care explorations · 2025Pooled it
- Integrated haemodynamic monitoring of fluid responsiveness and fluid tolerance in critical care: from physiology to bedside applications.Journal of clinical monitoring and computing · 2026Review
- Venous dimension of shock: Integrating arterial inflow and venous back-pressure in hemodynamic assessment.World journal of critical care medicine · 2026Review
- Drowning the kidneys: from fluid overload to physiology-guided fluid management in onco-hematology.Clinical kidney journal · 2026Review
- The usual suspects: a pragmatic framework to identify and address reversible contributors in apparent refractory septic shock.Critical care (London, England) · 2026Review
- A Guyton-based hypothesis for venous congestion.The ultrasound journal · 2026Article
- Dynamic indices of fluid responsiveness: physiological basis and clinical limits.Intensive care medicine · 2026Article
- Rethinking Congestion in Heart Failure from Volume Overload to Venous Pressure and Organ Disfunction with VExUS.Medicina (Kaunas, Lithuania) · 2026Review
- Integrating structured point-of-care ultrasound into dengue fever management: A mini review and comprehensive clinical guide.World journal of critical care medicine · 2026Review
- Extracorporeal membrane oxygenation, acute kidney injury, fluid balance, and continuous renal replacement therapy: Acute Disease Quality Initiative (ADQI) and Extracorporeal Life Support Organization (ELSO) joint consensus conference.Intensive care medicine · 2026Article
- Central Venous Pressure Revisited: Physiology, Pitfalls, Misconceptions, and Modern Clinical Interpretation in Critical Care.Journal of clinical medicine · 2026Review
- Reply to: Comment on "Comparison of standardized diaphragm ultrasound measurement and conventional methods for predicting weaning failure: a prospective observational study".Journal of anesthesia · 2026Article
- VExUS versus CVP for assessing venous congestion: oasis or mirage?Critical care (London, England) · 2026Article
- Lung and Venous Excess Ultrasound Correlation With Intracardiac Pressures Before and After Decongestion in Critically Ill Patients With Acute Decompensated Heart Failure.Critical care explorations · 2026Observational
- The role of thoracic ultrasound in fluid management in critical care: a narrative review.Journal of thoracic disease · 2026Review
- Relationship between high VExUS score and echocardiographic parameters: a systematic review and meta-analysis.Journal of anesthesia, analgesia and critical care · 2026Review
- Fluid responsiveness and changes in venous congestion and lung water during volume expansion in critically ill patients: a multicentre observational study.Critical care (London, England) · 2026Observational
- Venous excess and lung ultrasound during continuous renal replacement therapy in critically ill patients (VExLUS-RRT): a prospective observational study.Annals of intensive care · 2026Article
- Pushing the needle beyond preload: toward dynamic evaluation of venous congestion.Critical care science · 2026Article
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Authors and funding
18 authors at 6 institutions in 7 countries.
Funding
Abstract
backgroundCurrent 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.
methodsMulticenter, 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.
resultsNinety 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.
conclusionsVenous 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.
Indexed as
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.