VExUS Score and AKI in Critically Ill Adult patients-a Prospective Observational Study.

Tribhuvan University Teaching Hospital, Institute Of Medicine.

Status: Completed

Conditions: Acute Kidney Injury; VExUS

Study type: Observational

Funder types: Other

Identifiers

NCT06889116

438(6-11)E2- 079/080

Details and patient eligibility

About

Introduction Renal perfusion is dependent on the renal perfusion pressure across the renal capillaries. Venous congestion due to excess fluid therapy can drastically reduce the renal perfusion pressure in spite of a normal mean arterial pressure. Increasing cumulative fluid balance during the ICU stay has been found to be associated with negative outcomes including acute kidney injury (AKI) and hospital mortality. Venous excess ultrasound (VExUS) to assess the Doppler studies of renal, hepatic and portal veins along with the inferior venacava has been shown to reliably predict the incidence of AKI in certain ICU patient population more specifically in cardiorenal syndrome. The aim of this study was to correlate the incidence of AKI and VExUS scores in a mixed ICU population and hence determine the contribution of venous congestion on the causation of AKI in a general ICU.

Methods:

The patients included who have AKI at admission or developed AKI during their ICU stay were included. The definition of AKI used for this study was as defined by Kidney Disease: Improving Global Outcomes (KDIGO). Point of care VExUS scans were done on each patient at inclusion (day 0), then each day for a total of 4 days (day 1, 2 and 3), till initiation of renal replacement therapy, death or discharge form the ICU. Correlation between VExUS grades and creatinine clearances was explored as the primary objective.

Enrollment: 52 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥18 years
• Admitted to the adult ICUs of TUTH (ICU A and ICU B)
• Admitting diagnosis of AKI or who developed AKI during their ICU stay

Exclusion criteria

• Pregnancy
• Diagnosed case of chronic kidney disease
• Diagnosed case of cirrhosis/ portal hypertension
• Arrhythmias which would interfere with the acquisition and interpretation of the Doppler waveforms
• Inferior venacava thrombus
• Poor window for assessment

Trial design

52 participants in 1 patient group

Patients with AKI

Description:

Patients who are admitted with the diagnosis of AKI or develop AKI during their ICU stay