Evaluation of Venous Congestion Using Doppler and Venous Excess Ultrasound Score (VExUS) During Acute Respiratory Distress Syndrome and Its Association with Acute Kidney Injury

What this Trial Is About

This research aims to determine how common venous congestion is in adults with acute respiratory distress syndrome (ARDS) using venous Doppler ultrasound and the Venous Excess Ultrasound Score (VExUS). Acute kidney injury (AKI) often occurs in ARDS patients and is linked to higher death rates. Venous congestion may play a key role in this, but current methods to assess it may be unreliable. The study seeks to identify congestion early in patients needing mechanical ventilation and catecholamine support. Participants are adults with moderate to severe ARDS admitted to the intensive care unit and on invasive mechanical ventilation for less than 48 hours. Within 48 hours of starting ventilation, they will receive a multi-site venous Doppler ultrasound alongside cardiac ultrasound to assess venous congestion. This Doppler evaluation will be repeated on Day 7 of ventilation or during catecholamine weaning, whichever comes first. The study does not require any other investigations. Patients will be followed throughout their ICU stay and for three months after discharge if they survive, to monitor for chronic kidney disease after hospitalization. Researchers will collect demographic, clinical, and biological data to evaluate the proportion of patients with a VExUS score of 1 or higher within 48 hours of ventilation. They will also study how different VExUS grades relate to major kidney events within 30 days, including death, dialysis dependence, or significant creatinine increase.

VExUS in Ards Patients and Association with AKI