[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"venous-congestion\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:venous-congestion":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,11,0,[8,47,81,110,132,158,181,201,224,246,276],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":23,"conditions":24,"keywords":28,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":35,"lastUpdatePostDateStruct":36,"startDateStruct":39,"completionDateStruct":41,"leadSponsor":43,"locationsCount":46},"100634279","right-ventriculo-arterial-coupling-during-fluid-loading-in-icu-patients-100634279",false,"NCT07537621","Right Ventriculo-Arterial Coupling During Fluid Loading in ICU Patients","Prospective Observational Study of Right Ventriculo-arterial Coupling Changes During Fluid Loading and Their Relationship With Congestion Parameters in Critically Ill Adults","RVPA-FLICU","Inclusion criteria:\n\n* Critically ill hospitalized patients\n* Age ≥ 18 years\n* Patients undergoing fluid loading at the discretion of the attending physician, following prediction of fluid responsiveness using any recommended maneuver or dynamic parameter, in the setting of acute circulatory failure requiring vasopressor support and\u002For mean arterial pressure \\\u003C 65 mmHg (or a decrease of ≥ 30 mmHg from baseline in patients with chronic hypertension), and\u002For other signs of hemodynamic instability (tachycardia, mottling, oliguria, hyperlactatemia)\n* Affiliated with a national health insurance system\n\nExclusion criteria :\n\n* Formal refusal from the patient or legally representative after information\n* Patients transferred from another intensive care unit\n* Pregnant or postpartum patients\n* Acute respiratory distress (defined as respiratory rate ≥ 35 breaths\u002Fmin and\u002For signs of increased work of breathing)\n* Ongoing acute coronary syndrome\n* Acute or pulmonale (defined by right ventricular dilation associated with paradoxical septal motion related to an abrupt increase in right ventricular afterload)\n* Primary pulmonary arterial hypertension\n* Intra-abdominal hypertension (intravesical pressure \\> 15 mmHg)\n* Poor echogenicity precluding adequate echocardiographic assessment of the right ventricle\n* Severe valvular heart disease or early postoperative period following valvular surgery","ALL","18 Years",{"count":20,"type":21},100,"ESTIMATED","OBSERVATIONAL","Preload responsiveness and venous congestion have largely been investigated independently in recent literature. However, recent data report a similar incidence of venous congestion regardless of fluid responsiveness status, challenging the concept of a linear continuum between preload independence and fluid intolerance. These findings support the need for a more individualized hemodynamic management strategy that takes venous congestion risk into account.\n\nThe right ventricle plays a central role in this framework. Its function is to maintain an adequate venous return pressure gradient to ensure cardiac output while limiting upstream venous congestion, under strong dependence on its afterload. In physiological conditions, the right ventricle adapts to changes in afterload by increasing contractility to preserve right ventriculo-arterial coupling and optimize its performance.\n\nIn chronic cardiopulmonary diseases, right ventriculo-arterial uncoupling is a well-established prognostic factor, including the presence of occult uncoupling revealed by fluid loading. In critically ill patients, right ventricular systolic dysfunction associated with venous congestion-defining right heart failure-is strongly associated with increased mortality, as is right ventriculo-arterial uncoupling itself.\n\nTo support the concept of fluid tolerance, the investigators hypothesize that impairment of right ventriculo-arterial coupling may exist or occur during fluid loading in critically ill patients, independently of preload responsiveness, and may be associated with worsening upstream venous congestion.",[25,26,27],"Shock","Right Ventricular Dysfunction","Venous Congestion",[29,30,31,32,33],"Right ventriculo-arterial coupling","Fluid loading","Venous congestion","VEXUS score","Critical care echocardiography","RECRUITING","2026-06-09",{"date":37,"type":38},"2026-06-10","ACTUAL",{"date":40,"type":38},"2026-06-03",{"date":42,"type":21},"2029-06-04",{"name":44,"class":45},"CHU de Reims","OTHER",1,{"id":48,"slug":49,"hasResults":11,"nctId":50,"briefTitle":51,"officialTitle":51,"acronym":52,"eligibilityCriteria":53,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":54,"targetDuration":4,"studyType":56,"phases":57,"briefSummary":59,"conditions":60,"keywords":64,"overallStatus":70,"whyStopped":4,"lastUpdateSubmitDate":71,"lastUpdatePostDateStruct":72,"startDateStruct":74,"completionDateStruct":76,"leadSponsor":78,"locationsCount":80},"100635908","vexus-assessment-and-natriuresis-guided-diuretic-therapy-in-acute-heart-failure-100635908","NCT07558798","Vexus Assessment and Natriuresis-guided Diuretic Therapy in Acute Heart Failure","VANTAGE-HF","Inclusion Criteria:\n\n* Age \\>18 years\n* Hospitalization with AHF, either de novo or worsening of chronic HF\n* Able to provide written informed consent\n* Requirement of intravenous loop diuretic treatment as judged by the treating physician\n\nExclusion Criteria:\n\n* Dyspnea primarily due to non-cardiac causes\n* Advanced renal disease or estimated glomerular filtration rate (eGFR) \\\u003C 20 mL\u002Fmin\u002F1.73m2 at screening or on-going dialysis.\n* Enrollment in another study interfering with the treatment algorithm of the current study\n* Inability to follow the treatment protocol\n* Language barriers requiring the need for an external interpreter\n* Pregnant or nursing (lactating) women\n* Very short life expectancy (\\\u003C30 days)",{"count":55,"type":21},270,"INTERVENTIONAL",[58],"NA","This study evaluates whether natriuresis-guided diuretic therapy improves outcomes in patients with acute heart failure (AHF) and severe congestion. All patients hospitalized with AHF will be screened using Venous Excess Ultrasound (VExUS) and randomized 1:1 to either natriuresis-guided escalation of loop diuretics or standard care. The primary endpoint, evaluated in patients with VExUS grade 3 (severe congestion), is a hierarchical composite (win ratio) of 90-day mortality, 90-day rehospitalization, and hospital length of stay. Key secondary endpoints (hierarchical) include (1) difference in win ratio between patients with VExUS 3 versus VExUS 0-2 at hospital admission (assessed by interaction testing and statistically tested only if the primary endpoint is significant) and (2) win ratio (primary endpoint) tested among patients with VExUS 0-2 at hospital admission (statistically tested only if the first key seconday endpoint is significant). Exploratory endpoints include in-hospital clinical, hemodynamic, and biochemical outcomes (mortality, eGFR, NT-proBNP, NYHA class, VExUS score, natriuresis\u002Fdiuresis, and patient-reported dyspnea), associations between congestion markers (VExUS, FibroScan, lung ultrasound, clinical score, and NT-proBNP), as well as quality of life at 90 days, GDMT optimization score at discharge, and long-term time to readmission and mortality assessed through registry linkage.",[27,61,62,63],"Heart Failure Acute","VExUS","Diuretics",[65,66,67,68,69],"loop diuretics","heart failure","acute heart failure","vexus","congestion","NOT_YET_RECRUITING","2026-04-23",{"date":73,"type":38},"2026-04-30",{"date":75,"type":21},"2026-04",{"date":77,"type":21},"2028-06",{"name":79,"class":45},"University Hospital, Akershus",2,{"id":82,"slug":83,"hasResults":11,"nctId":84,"briefTitle":85,"officialTitle":85,"acronym":86,"eligibilityCriteria":87,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":88,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":90,"conditions":91,"keywords":97,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":101,"lastUpdatePostDateStruct":102,"startDateStruct":104,"completionDateStruct":106,"leadSponsor":108,"locationsCount":46},"100596975","association-of-microcirculation-vexus-score-and-femoral-vein-doppler-in-patients-on-the-icu-after-non-emergency-cardiac-surgery-100596975","NCT07052461","Association of Microcirculation, Vexus Score and Femoral Vein Doppler in Patients on the ICU After Non-emergency Cardiac Surgery","VeMic","Inclusion Criteria:\n\n* Age ≥ 18 years\n* Elective or urgent (need for definitive procedure during hospitalisation, but not emergency intervention) cardiac surgery\n\nExclusion Criteria:\n\n* Age \\\u003C 18 years\n* Pregnant women\n* Known severe chronic kidney disease (estimated glomerular filtration rate \\\u003C15 mL\u002Fmin per 1.73 m2 or dialysis)\n* Renal or liver transplantation\n* Any known condition interfering with Doppler evaluation of the portal system (including known or suspected cirrhosis or portal vein thrombosis or huge abdominal emphysema).\n* Inability to consent to study\n* Emergency cardiac surgery",{"count":89,"type":21},40,"The aim of the VeMic study is to explore if venous congestion is linked with microcirculatory impairment in elective cardiac surgery patients in the postoperative ICU stay.",[92,93,27,94,95,96],"Microcirculatory Diffusion","Microcirculatory Convection Capacity","Postoperative Cardiac Surgery","Fluid Management","Haemodynamic Coherence",[98,99,100],"vexus score","femoral vein doppler","intensive care unit","2026-04-15",{"date":103,"type":38},"2026-04-20",{"date":105,"type":38},"2026-04-14",{"date":107,"type":21},"2027-09-30",{"name":109,"class":45},"University Hospital, Basel, Switzerland",{"id":111,"slug":112,"hasResults":11,"nctId":113,"briefTitle":114,"officialTitle":114,"acronym":115,"eligibilityCriteria":116,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":117,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":119,"conditions":120,"keywords":4,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":123,"lastUpdatePostDateStruct":124,"startDateStruct":126,"completionDateStruct":128,"leadSponsor":130,"locationsCount":46},"100631340","evaluation-of-the-microcirculatory-response-to-fluids-in-critically-ill-patients-with-venous-congestion-a-prospective-observational-study-100631340","NCT07499401","Evaluation of the Microcirculatory Response to Fluids in Critically Ill Patients With Venous Congestion: A Prospective Observational Study","MICRO-CONGEST","Inclusion Criteria:\n\n* Critically ill patients admitted to the intensive care unit\n* Invasive or minimally invasive hemodynamic monitoring\n\nExclusion Criteria:\n\n* Suspected or confirmed pregnancy\n* Inability to access the oral cavity (e.g., facial trauma, oral bleeding)",{"count":118,"type":21},30,"The hypothesis is that fluid-responsive patients who show signs of venous congestion experience a worsening of microcirculatory status after fluid administration compared to patients without signs of venous congestion",[27,121,122],"Microcirculation","Volume Expansion","2026-03-28",{"date":125,"type":38},"2026-04-02",{"date":127,"type":38},"2024-12-15",{"date":129,"type":21},"2026-06",{"name":131,"class":45},"Università Politecnica delle Marche",{"id":133,"slug":134,"hasResults":11,"nctId":135,"briefTitle":136,"officialTitle":136,"acronym":137,"eligibilityCriteria":138,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":139,"targetDuration":4,"studyType":56,"phases":141,"briefSummary":142,"conditions":143,"keywords":144,"overallStatus":70,"whyStopped":4,"lastUpdateSubmitDate":149,"lastUpdatePostDateStruct":150,"startDateStruct":152,"completionDateStruct":154,"leadSponsor":156,"locationsCount":46},"100626621","vexus-rea--evaluation-of-ultrasound-parameters-of-venous-congestion-in-patients-in-a-medical-intensive-care-unit-100626621","NCT07438015","VEXUS-REA : Evaluation of Ultrasound Parameters of Venous Congestion in Patients in a Medical Intensive Care Unit","VEXUS-REA","Inclusion Criteria:\n\n* Patients admitted to medical intensive care at Besançon Teaching Hospital for any reason.\n* Aged over 18.\n* Affiliated with a French social security scheme or beneficiary of such a scheme.\n* No objection to participating in the study.\n\nNon-inclusion criteria :\n\n* Minors\n* Pregnant women and breastfeeding mothers\n* Persons deprived of their liberty by judicial or administrative decision; persons undergoing compulsory psychiatric treatment; persons admitted to a health or social care institution for purposes other than research\n* Adults subject to legal protection measures or unable to give their consent\n* Subjects who are excluded from another study or listed in the 'national volunteer registry'.\n\nExclusion Criteria:\n\n\\- Portal vein, suprahepatic or femoral vein thrombosis at the time of ultrasound examination.",{"count":140,"type":21},525,[58],"Shock is a common and serious cause of admission to intensive care. Vascular filling is one of the cornerstones of shock treatment, aimed at increasing cardiac output and restoring adequate organ perfusion through rapid intravenous administration of a solution. However, this vascular filling can be accompanied by venous congestion, which can be harmful. Fluid administration must therefore be sparing and carefully considered.\n\nHowever, it is difficult to assess the correct amount of intravenous fluid to inject. Multi-site venous ultrasound (inferior vena cava, suprahepatic vein, portal vein, renal vein), recently published under a score called VExUS, could be a useful bedside tool for documenting venous congestion and avoiding excessive vascular filling. Nevertheless, this tool has been little evaluated in the general intensive care population, particularly in patients with acute respiratory distress syndrome (ARDS). Its link with other venous sites (femoral, popliteal) has also been little studied to date.\n\nThe main objective of our study is to describe the distribution of the VEXUS score among patients in a general intensive care unit.\n\nThe secondary objectives are:\n\n* To study the feasibility of measuring the VEXUS score in patients with ARDS, including during prone positioning, a recommended and frequently used treatment for this condition, which could make it difficult to acquire venous ultrasound data.\n* In this case, other more accessible venous flows could be analysed, namely the femoral venous flow and the popliteal venous flow. We will therefore also study their feasibility during prone positioning sessions.\n* Subsequently, we will study the correspondence between the VEXUS score and these other types of venous flow (femoral, popliteal).\n* Finally, we will evaluate the association between the VEXUS score in our general intensive care population and the long-term prognosis of patients, in this case death on day 28 and the occurrence of acute renal failure requiring renal replacement therapy during the intensive care stay.",[27],[145,146,147,148],"VExUS score","venous congestion","femoral venous flow","popliteal venous flow","2026-02-20",{"date":151,"type":38},"2026-02-27",{"date":153,"type":21},"2026-03-01",{"date":155,"type":21},"2026-10-01",{"name":157,"class":45},"Centre Hospitalier Universitaire de Besancon",{"id":159,"slug":160,"hasResults":11,"nctId":161,"briefTitle":162,"officialTitle":163,"acronym":4,"eligibilityCriteria":164,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":165,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":167,"conditions":168,"keywords":4,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":172,"lastUpdatePostDateStruct":173,"startDateStruct":175,"completionDateStruct":177,"leadSponsor":179,"locationsCount":46},"100614868","venous-congestion-and-delirium-after-cardiac-surgery-100614868","NCT07285187","Venous Congestion And Delirium After Cardiac Surgery","Intraoperative Venous Congestion And Delirium After Cardiac Surgery: A Prospective Cohort Study","Inclusion Criteria:\n\n1. Patients scheduled to undergo elective cardiac surgery via a midline thoracic incision;\n2. ≥18 years;\n3. A preoperative MMSE score\\>23, without consciousness or language barriers, capable of cooperating with neurological examinations, cognitive function tests, and other assessments of neurological function.\n\nExclusion Criteria:\n\n1. Contraindications for TEE;\n2. Emergency cardiac surgery;\n3. Major vascular surgery;\n4. Redo cardiac surgery;\n5. Severe infection requiring continuous antibiotic therapy;\n6. Severe preoperative heart failure with left ventricular ejection fraction \\\u003C 30%;\n7. A critical preoperative state (mechanical circulatory support, extracorporeal membrane oxygenation, current renal replacement therapy, mechanical ventilation, or cardiac arrest necessitating resuscitation);\n8. Multi-organ dysfunction;\n9. Known conditions that may interfere with the assessment or interpretation of hepatic vein, portal vein blood flow (such as liver cirrhosis or portal vein thrombosis) or the renal vein blood flow (such as urinary tract obstruction);\n10. Planned cardiac transplantation or ventricular assist device implantation;\n11. Pregnancy;\n12. Insufficient ultrasonographic imaging;\n13. Restarting CPB after first CPB cessation during surgery;\n14. Requirement for cardiac assist devices (ECMO, IABP, or ventricular assist device) after CPB intraoperatively;\n15. Neurological or psychiatric diagnoses that may affect cognitive performance or cognitive testing;\n16. Documented delirium before surgery.",{"count":166,"type":21},120,"Postoperative delirium (POD) is an acute brain dysfunction characterized by inattention, impaired consciousness, and cognitive and orientation disturbances, and is a common complication after cardiac surgery. The high incidence of up to 52% of POD in cardiac surgery patients lead to a range of adverse clinical outcomes.The brain tissue is enclosed in a rigid anatomical structure; when there is an obstruction to venous return from the brain, intracranial pressure can increase, and blood supply to the brain tissue can decrease, leading to central nervous system dysfunction.\n\nSystemic venous congestion can occur when there is right heart dysfunction or excessive volume load. When right heart failure and\u002For volume overload occurs, changes in right atrial pressure are transmitted to the venous system of organs throughout the body, with dilatation of the inferior vena cava (IVC), obstruction of blood return from the hepatic, portal, and renal veins, and abnormal venous flow signals and altered ultrasound Doppler flow patterns.\n\nThe primary objective of this prospective cohort study is to explore if intraoperative systemic venous congestion is associated with POD after cardiac surgery. This study will also investigate the relationship between intraoperative systemic venous congestion and postoperative complications, and the relationship between each separate venous congestion and POD after cardiac surgery.",[169,27,170,171],"Intraoperative","Postoperative Delirium (POD)","Cardiac Surgery","2025-12-16",{"date":174,"type":38},"2025-12-23",{"date":176,"type":38},"2024-11-01",{"date":178,"type":21},"2026-10-31",{"name":180,"class":45},"Zhuan Zhang",{"id":182,"slug":183,"hasResults":11,"nctId":184,"briefTitle":185,"officialTitle":186,"acronym":4,"eligibilityCriteria":187,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":188,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":190,"conditions":191,"keywords":4,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":193,"lastUpdatePostDateStruct":194,"startDateStruct":196,"completionDateStruct":198,"leadSponsor":200,"locationsCount":46},"100610799","venous-congestion-and-cardiac-surgery-associated-acute-kidney-injury-100610799","NCT07232277","Venous Congestion and Cardiac Surgery-Associated Acute Kidney Injury","Intraoperative Venous Congestion and Cardiac Surgery-associated Acute Kidney Injury (CSA-AKI): a Prospective Cohort Study","Inclusion Criteria:\n\n1. Patients scheduled to undergo elective cardiac surgery;\n2. ≥ 18 years.\n\nExclusion Criteria:\n\n1. Contraindications for TEE;\n2. Emergency cardiac surgery;\n3. Major vascular surgery;\n4. Redo cardiac surgery;\n5. Abnormal preoperative renal function;\n6. Severe chronic kidney disease (estimated glomerular filtration rate \\\u003C 15 ml\u002Fmin\u002F1.73 m2 or dialysis);\n7. History of kidney transplantation;\n8. Severe infection requiring continuous antibiotic therapy；\n9. Severe preoperative heart failure with left ventricular ejection fraction \\\u003C 30%;\n10. A critical preoperative state (mechanical circulatory support, extracorporeal membrane oxygenation, current renal replacement therapy \\[RRT\\], mechanical ventilation, or cardiac arrest necessitating resuscitation);\n11. Multi-organ dysfunction;\n12. Known conditions that may interfere with the assessment or interpretation of hepatic vein, portal vein blood flow (such as liver cirrhosis or portal vein thrombosis) or the renal vein blood flow and renal artery blood flow (such as urinary tract obstruction);\n13. Planned cardiac transplantation or ventricular assist device implantation;\n14. Pregnancy;\n15. Insufficient ultrasonographic imaging;\n16. Restarting CPB after first CPB cessation during surgery;\n17. Requirement for cardiac assist devices (ECMO, IABP, or ventricular assist device) after CPB intraoperatively.",{"count":189,"type":21},114,"Venous pressure is often overlooked as an important hemodynamic parameter. Elevated venous pressure and blood stasis in organ tissues can lead to interstitial edema. Intraoperative venous blood stasis can rapidly increase interstitial pressures within organ tissues, especially in organs encapsulated by tissue envelopes, such as the kidney, thereby rapidly reducing effective circulating blood flow to the organ. Systemic venous blood stasis, which tends to occur in patients with right heart failure or pulmonary hypertension, as well as in patients with fluid overload, can lead to intraoperative stasis in multiple organs and tissues, mediating the development of multisystem complications, including acute kidney injury. Therefore, timely, effective, and accurate intraoperative assessment of systemic venous blood stasis is particularly important.\n\nWhen right heart failure and\u002For volume overload occurs in the body, changes in right atrial pressure are transmitted to the venous system of organs throughout the body, with dilatation of the inferior vena cava (IVC), obstruction of blood return from the hepatic, portal, and renal veins, and abnormal venous flow signals and altered ultrasound Doppler flow patterns.\n\nThe primary objective of this prospective cohort study is to explore if intraoperative systemic venous congestion during cardiac surgery is associated with postoperative CSA-AKI. In doing so, we seek to identify a promising physiological marker that can provide cues for the prediction of CSA-AKI. This study will also investigate the relationship between intraoperative systemic venous congestion and postoperative complications, and explore the relationship between each separate venous congestion and AKI after cardiac surgery.",[169,27,192],"Cardiac Surgery-associated Acute Kidney Injury","2025-11-13",{"date":195,"type":38},"2025-11-18",{"date":197,"type":38},"2024-10-15",{"date":199,"type":21},"2026-09-30",{"name":180,"class":45},{"id":202,"slug":203,"hasResults":11,"nctId":204,"briefTitle":205,"officialTitle":205,"acronym":206,"eligibilityCriteria":207,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":208,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":210,"conditions":211,"keywords":4,"overallStatus":70,"whyStopped":4,"lastUpdateSubmitDate":215,"lastUpdatePostDateStruct":216,"startDateStruct":218,"completionDateStruct":220,"leadSponsor":222,"locationsCount":4},"100607041","impact-of-fluid-resuscitation-on-venous-congestion-in-cardiac-critically-ill-patients-100607041","NCT07183397","Impact of Fluid Resuscitation on Venous Congestion in Cardiac Critically-ill Patients","VExUS-CS","Inclusion Criteria:\n\n* Age above 18 years\n* Admission to cardiac intensive care unit",{"count":209,"type":21},250,"The objective of this study is to assess how fluid resuscitation, in the context of fluid responsiveness, affects the incidence and progression of systemic venous congestion in critically ill cardiac patients. Additionally, the study aims to evaluate the impact on clinical outcomes, with a particular focus on acute kidney dysfunction. This assessment will utilize the VExUS score in conjunction with comprehensive bedside echocardiographic evaluations.",[212,213,27,214],"Cardiac and Aortic Surgery","Cardiac Anaesthesia","Fluid Resuscitation","2025-09-14",{"date":217,"type":38},"2025-09-19",{"date":219,"type":21},"2025-09-15",{"date":221,"type":21},"2027-12",{"name":223,"class":45},"Medical University of Vienna",{"id":225,"slug":226,"hasResults":11,"nctId":227,"briefTitle":228,"officialTitle":228,"acronym":229,"eligibilityCriteria":230,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":231,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":233,"conditions":234,"keywords":235,"overallStatus":70,"whyStopped":4,"lastUpdateSubmitDate":237,"lastUpdatePostDateStruct":238,"startDateStruct":240,"completionDateStruct":242,"leadSponsor":244,"locationsCount":4},"100603031","changes-in-portal-vein-pulsatility-variability-during-a-tidal-volume-challenge-can-predict-fluid-tolerance-100603031","NCT07131228","Changes in Portal Vein Pulsatility Variability During a Tidal Volume Challenge Can Predict Fluid Tolerance","SERLU","Inclusion Criteria:\n\nParticipants must meet all of the following:\n\nAge ≥ 18 years at the time of enrollment.\n\nReceiving controlled mechanical ventilation with a baseline tidal volume of 6 mL\u002Fkg of predicted body weight.\n\nClinical indication for assessment of fluid responsiveness.\n\nAdequate acoustic window for ultrasound visualization of the portal vein.\n\nExclusion Criteria:\n\nParticipants will be excluded if they have any of the following:\n\nLiver cirrhosis.\n\nRight heart failure, defined as any of the following on prior echocardiography:\n\nTricuspid annular plane systolic excursion (TAPSE) \\\u003C 16 mm\n\nS' wave \\\u003C 10 cm\u002Fs\n\nRight ventricular fractional area change \\\u003C 35%\n\nLeft heart failure (left ventricular ejection fraction \\\u003C 50%).\n\nIntra-abdominal hypertension.\n\nAtrial fibrillation or other significant cardiac arrhythmias.\n\nTricuspid regurgitation.\n\nPoor echogenic window preventing adequate ultrasound assessment.\n\nPresence of spontaneous breathing activity.",{"count":232,"type":21},60,"In critically ill patients, appropriate fluid administration is one of the cornerstones of hemodynamic management, as both hypovolemia and fluid overload can negatively impact clinical outcomes.\n\nFor years, fluid responsiveness-defined as an increase in cardiac output following volume administration-has guided decision-making in the postoperative ICU. However, fluid responsiveness alone does not guarantee fluid tolerance, which refers to the venous system's ability to accommodate volume without developing venous congestion or adverse effects such as pulmonary edema, renal or hepatic dysfunction.\n\nThe tidal volume challenge (TVC)-which consists of a transient increase in tidal volume from 6 to 8 mL\u002Fkg-has been shown to predict fluid responsiveness by enhancing the hemodynamic interaction between the heart and lungs during the cardiac cycle, as measured through dynamic arterial indices such as pulse pressure variation (PPV) or stroke volume variation (SVV). However, these indices do not provide information about fluid tolerance or the state of venous congestion.\n\nDoppler ultrasound of the portal vein, specifically the portal pulsatility index (which under normal conditions presents as a continuous waveform due to the damping effects of the hepatic parenchyma and venous compliance), has been proposed as a non-invasive marker of systemic venous congestion. Studies have shown that an increase in the portal pulsatility index following volume loading may indicate the development of venous congestion and, therefore, poor fluid tolerance.\n\nSince the tidal volume challenge transiently increases intrathoracic pressure and allows dynamic evaluation of cardiovascular responses, we propose that this interaction be assessed not only through arterial dynamic indices (which assess responsiveness) but also through changes in venous flow patterns-specifically, variations in portal pulsatility-so that both fluid responsiveness and tolerance can be predicted with the same test.",[27],[236],"Fluid Responsiveness Fluid Tolerance","2025-08-17",{"date":239,"type":38},"2025-08-20",{"date":241,"type":21},"2025-11-01",{"date":243,"type":21},"2026-11-30",{"name":245,"class":45},"Dr. Negrin University Hospital",{"id":247,"slug":248,"hasResults":11,"nctId":249,"briefTitle":250,"officialTitle":251,"acronym":252,"eligibilityCriteria":253,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":254,"enrollmentInfo":255,"targetDuration":4,"studyType":56,"phases":256,"briefSummary":257,"conditions":258,"keywords":261,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":267,"lastUpdatePostDateStruct":268,"startDateStruct":270,"completionDateStruct":272,"leadSponsor":274,"locationsCount":80},"100535429","fluid-removal-guided-by-vexus-score-with-usual-care-in-patients-with-acute-kidney-injury-after-cardiac-surgery-100535429","NCT06251713","Fluid-removal Guided by VeXUS Score With Usual Care in Patients With Acute Kidney Injury After Cardiac Surgery","Feasibility of a Randomised Trial Comparing a Fluid-removal Guided by VeXUS Score With Usual Care in Patients With Acute Kidney Injury After Cardiac Surgery: a Pilot Randomised Trial.","VeXUS","Inclusion Criteria:\n\n* Intensive care unit admission within 72 hours of cardiac surgery with extracorporeal circulation\n* Acute kidney injury defined by KDIGO criteria\n* Vasoactive inotropic score \\\u003C45 and capillary refill time \\\u003C3s\n* Informed written consent\n\nExclusion Criteria:\n\n* Hypokalaemia \\\u003C3.5mmol\u002FL\n* Hyponatremia\\\u003C125mmol\u002FL\n* Hypernatremia \\>145mmol\u002FL\n* Metabolic alkalosis with pH \\>7.50\n* Impossibility to measure capillary refill time\n* Chronic liver disease\n* Cirrhosis with portal hypertension\n* Known thrombus of the inferior vena cava\n* Mechanical circulatory assistance (ECMO or mono left ventricular assistance)\n* Severe pre-operative chronic kidney disease (GFR \\\u003C 30mL\u002Fmin\u002F1.73m2)\n* Need for renal replacement therapy anticipated by the attending physician within 24 hours\n* Known hypersensitivity to Furosemide and\u002For hydrochlorothiazide\n* Severe allergy to wheat\n* Patient already included in another interventional study with an exclusion period still in progress\n* Pregnant, breast-feeding or women of childbearing age without suitable contraception\n* Patients under guardianship, curatorship or safeguard of justice\n* Patients under psychiatric care\n* Patients not affiliated to a social security scheme or beneficiaries of a similar scheme","85 Years",{"count":89,"type":21},[58],"Acute kidney injury affects more than 30% of patients after cardiac surgery, and is associated with an excess in mortality. There is a clinical continuum between acute kidney injury (transient if \\\u003C48h, persistent if \\>48h), the development of acute kidney and chronic renal failure. Each of these entities characterising renal recovery is associated with an increase in long-term morbidity and mortality. Fluid management in patients with acute kidney injury is challenging, as both hypovolaemia and hypervolaemia are detrimental. Venous congestion (reflecting intravascular hypervolaemia), is a well-established haemodynamic factor contributing to acute kidney injury after cardiac surgery. An ultrasound score, based on the venous doppler pattern explored in intra-abdominal organs, has recently been developed and is a better predictor of acute kidney injury than central venous pressure. Whether using the VeXUS score to guide fluid removal in haemodynamically stabilised patients could promote renal recovery after acute kidney injury remains to be investigated.\n\nBefore designing a large randomised trial to test such a strategy, its feasibility in a pilot randomised trial is assessed.",[259,171,27,260],"Acute Kidney Injury","Hemodynamic Stability",[262,263,27,264,265,266],"Acute kidney injury","Cardiac surgery","VeXUS score","diuretic","fluid removal","2025-04-09",{"date":269,"type":38},"2025-04-13",{"date":271,"type":38},"2024-07-31",{"date":273,"type":21},"2026-07",{"name":275,"class":45},"Hospices Civils de Lyon",{"id":277,"slug":278,"hasResults":11,"nctId":279,"briefTitle":280,"officialTitle":281,"acronym":282,"eligibilityCriteria":283,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":284,"enrollmentInfo":285,"targetDuration":287,"studyType":22,"phases":4,"briefSummary":288,"conditions":289,"keywords":4,"overallStatus":34,"whyStopped":4,"lastUpdateSubmitDate":293,"lastUpdatePostDateStruct":294,"startDateStruct":296,"completionDateStruct":298,"leadSponsor":300,"locationsCount":302},"100575419","fluid-responsiveness-and-venous-congestion-evolution-during-volume-expansion-100575419","NCT06772038","Fluid Responsiveness and Venous Congestion Evolution During Volume Expansion","Dynamic Assessment of Fluid Responsiveness and Venous Congestion: Evolution of the VExUS Score During Volume Expansion","FREVO","Inclusion Criteria:\n\n* Age ≥ 18 years\n* Hospitalized in the intensive care unit (ICU)\n* Hemodynamic monitoring in place, with a pulse wave contour analysis- derived estimation of cardiac output (either calibrated or uncalibrated)\n* Decision made by clinicians to perform volume expansion through intravenous infusion of crystalloid fluid\n\nExclusion Criteria:\n\n* Pregnancy\n* Refusal to participate by relatives of the patient or the patient himself","99 Years",{"count":286,"type":21},64,"1 Month","Fluid responsiveness is a critical determinant guiding fluid therapy in critically ill patients. However, excessive fluid administration can result in fluid overload, leading to venous congestion and worse clinical outcomes. Venous congestion, a marker of impaired fluid clearance, is increasingly recognized as a significant contributor to poor prognosis. Previous studies have demonstrated the coexistence of fluid responsiveness and venous congestion in critically ill patients. Notably, these studies were limited by the absence of fluid challenge-the gold standard for assessing fluid responsiveness-leaving the dynamic relationship between fluid responsiveness and venous congestion incompletely understood. This study aims to investigate the interplay and temporal evolution of fluid responsiveness and venous congestion following a standardized fluid challenge in critically ill patients.",[290,291,27,292],"Hemodynamic","Fluid Responsiveness","Fluid Challenge","2025-01-08",{"date":295,"type":38},"2025-01-13",{"date":297,"type":21},"2025-01-05",{"date":299,"type":21},"2025-07-30",{"name":301,"class":45},"Bicetre Hospital",3]