Evidence map›Paper›PMID 41879150›Full record

Observational studyAnaesthesiology intensive therapy2026

The fluid paradox: dissociation between clinical and ultrasound parameters of fluid overload - results of the INCIVEX exploratory study.

Adrian Wong, Kim Cheah, Georgios Papathanakos, Federico Stefanini, Mateusz Zawadka

Abstract readObservational Study
In one paragraph

Observational study in Anaesthesiology intensive therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Adrian WongDepartment of Critical Care, King's College Hospital, London, UK.
Kim CheahDepartment of Critical Care, King's College Hospital, London, UK.
Georgios PapathanakosDepartment of Intensive Care Medicine, University of Ioannina, Ioannina, Epirus, Greece.
Federico StefaniniDepartment of Critical Care, King's College Hospital, London, UK.
Mateusz Zawadka2nd Department of Anaesthesia and Intensive Care, Medical University of Warsaw, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFluid management in critically ill patients relies on clinical assessment, fluid balance calculations and, increasingly, point-of-care ultrasound. However, the rela-tionships between these assessment modalities remain poorly understood, with conflicting evidence regarding their correlation and clinical utility. The study aimed to eva-luate correlations between clinical indicators of fluid overload, cumulative fluid balance, and comprehensive ultrasound parameters including cardiac function, lung ultrasound, and the venous excess ultrasound (VExUS) protocol in critically ill patients. MATERIAL AND

methodsWe conducted a cross-sectional, observational study in a tertiary intensive care unit. Adults admitted for ≥ 72 hours with clinical evidence of fluid overload but haemodynamic stability were eligible. Assessments included focused echocardiography, six-zone lung ultrasound, and comprehensive VExUS. Correlations between cumulative fluid balance, clinical oedema, and ultrasound parameters were analysed.

resultsOf 195 patients screened, 50 were recruited to the study. The study population had a mean age of 59 years. Sepsis and respiratory failure were the most common admission diagnoses. The mean cumulative fluid balance was 7.1 ± 4.8 L at the time of recruitment. Peripheral oedema was present in over 70%. Ultrasound revealed left ventricular dysfunction in 16%, right ventricular dysfunction in 10%, bilateral pleural effusions in 44%, and elevated VExUS scores (> 2) in 20%. Cumulative fluid balance showed no correlation with clinical or ultrasound findings.

conclusionsTraditional fluid assessment (cumulative fluid balance and clinical signs of oedema) methods show no correlation with ultrasound parameters in critically ill patients. Future research should focus on ultrasound-guided approaches that provide cardiovascular assessment rather than on cumulative fluid balance calculations or clinical signs alone.

Indexed as

Critical IllnessFluid TherapyWater-Electrolyte BalanceWater-Electrolyte ImbalanceAgedCross-Sectional StudiesEchocardiographyEdemaFemaleHumansIntensive Care UnitsMaleMiddle AgedPoint-of-Care SystemsUltrasonographyde resuscitationfluid balancefluid overloadoedema assessmentpoint-of-care ultrasoundvenous congestionVExUS

Identifiers

PMID41879150
PMCPMC13085044

What Socratic holds

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Registered trials

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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.