ArticleAnnals of intensive care2024
Changes in portal pulsatility index induced by a fluid challenge in patients with haemodynamic instability and systemic venous congestion: a prospective cohort study.
Article in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- A Guyton-based hypothesis for venous congestion.The ultrasound journal · 2026Article
- Rethinking Congestion in Heart Failure from Volume Overload to Venous Pressure and Organ Disfunction with VExUS.Medicina (Kaunas, Lithuania) · 2026Review
- A comprehensive review of venous excess ultrasound (VExUS) score: evidence from original research.Internal and emergency medicine · 2026Review
- Role of hepatic and portal venous Doppler in constrictive pericarditis: insights from a case series.European heart journal. Case reports · 2026Article
- 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
- Pushing the needle beyond preload: toward dynamic evaluation of venous congestion.Critical care science · 2026Article
- VExUS score: optimizing its use in perioperative and critical care management.Critical care (London, England) · 2025Review
- The intricate relationship between capillary refill time and systemic hemodynamics in septic shock.Annals of intensive care · 2025Review
- Decoding portal vein pulsatility: hemodynamic determinants in a post-hoc analysis of a prospective observational trial.Annals of intensive care · 2025Article
- Relationship between point-of-care ultrasound venous congestion assessment parameters, intravenous pressure, and venous return: a post-hoc analysis of a prospective cohort study.The ultrasound journal · 2025Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is uncertain whether fluid administration can improve patients with systemic venous congestion and haemodynamic instability. This study aimed to describe the changes in systemic venous congestion and peripheral perfusion parameters induced by a fluid challenge in these patients, and to analyse the influence of the fluid responsiveness status on these changes.
methodsThe study is a single-centre prospective cohort study of 36 critically ill ICU patients with haemodynamic instability and a maximum vena cava diameter ≥ 20 mm. Changes in cardiac index during a fluid challenge (4 mL/kg of lactated Ringer's solution during 5 min) assessed by pulse contour analysis, central venous pressure, ultrasound systemic congestion parameters (portal venous flow pulsatility index, supra hepatic and intrarenal venous Doppler), and peripheral perfusion parameters (capillary refill time and peripheral perfusion index) were assessed in the overall population. All these data were compared between patients presenting a cardiac index increase > 10% during the fluid challenge (fluid responders) and the others (fluid non-responders).
resultsTwenty-eight (78%) patients were admitted for postoperative care following cardiac surgery; their mean ± SD left ventricular ejection fraction was 42 ± 9% and right ventricular dysfunction was found in at least 61% of the patients. The mean ± SD SOFA score was 9 ± 3. Thirteen (36%) patients were fluid responders. The fluid challenge administration induced a significant increase in portal pulsatility index, VExUS score, and central venous pressure without significant difference of these changes between fluid responders and non-responders. No significant change in perfusion parameters was observed.
conclusionFluid administration in patients with haemodynamic instability and systemic venous congestion worsens venous congestion regardless of the fluid responsiveness status, without improving perfusion parameters.
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