Hemodynamics, fluids & transfusion
Changes in portal pulsatility index induced by a fluid challenge in patients with haemodynamic instability and systemic venous congestion: a prospective cohort study
Authors' conclusion
Fluid administration in patients with haemodynamic instability and systemic venous congestion worsens venous congestion regardless of the fluid responsiveness status, without improving perfusion parameters.
Study context
- Population
- Critically ill ICU patients with haemodynamic instability and a maximum vena cava diameter ≥ 20 mm (systemic venous congestion)
- Participants
- 36 patients
- Exposure
- Fluid responders vs fluid non-responders to a fluid challenge
- Fluid respondersn = 13
- Outcome
- Changes in systemic venous congestion (portal venous flow pulsatility index, supra hepatic and intrarenal venous Doppler, CVP) and peripheral perfusion parameters (capillary refill time, peripheral perfusion index) induced by a fluid challenge (4 mL/kg lactated Ringer's over 5 min)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Fluid challenge induced a significant increase in portal pulsatility index, VExUS score and CVP, without significant difference of these changes between fluid responders and non-responders
- No significant change in perfusion parameters
Observational data: associations, not effects.
Original publication
Changes in portal pulsatility index induced by a fluid challenge in patients with haemodynamic instability and systemic venous congestion: a prospective cohort study. Ann Intensive Care. Published 1 November 2024. doi:10.
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