Rihl MF, Pellegrini JAS, Boniatti MM. VExUS Score in the Management of Patients With Acute Kidney Injury in the Intensive Care Unit: AKIVEX Study.
JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023;
42:2547-2556. [PMID:
37310104 DOI:
10.1002/jum.16288]
[Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/25/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVES
Venous congestion is a potential cause of acute kidney injury (AKI) and venous excess ultrasound (VExUS) score is a potentially useful tool in this scenario. The aim of this study is to verify whether the VExUS score can serve as a guide to decongestion in patients with severe AKI and whether the modification of the score can be associated with an increase in the number of renal replacement therapy (RRT)-free days in 28 days.
METHODS
This quasi-experimental study was conducted in patients admitted to the intensive care unit who developed severe AKI. The intervention was to suggest to the attending physician the use of diuretic in patients with VExUS >1. After 48 hours, a new VExUS assessment was performed. Primary outcome was RRT-free days at Day 28.
RESULTS
Ninety patients were included. Patients with a VExUS score >1 (n = 36) at enrollment had a greater use of diuretics in the following 48 hours (75.0%, n = 27) than patients with a VExUS ≤1 (n = 54) at enrollment (38.9%, n = 21), P = .001. Patients who reduced the VExUS score had a significantly greater number of RRT-free days at Day 28 (28.0; 8.0-28.0) when compared with those who did not reduce (15.0; 3.0-27.5), P = .012.
CONCLUSIONS
We found a higher diuretic use in patients with a higher VExUS score, and patients who reduced the VExUS in 48 hours had significantly more RRT-free days in 28 days.
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