The Impact of VeXUS-guided Fluid Management in ICU Populations on Renal Function
University of Alabama at Birmingham
Summary
This study will evaluate the use of the Venous Excess Ultrasound (VExUS) score to guide fluid management in critically ill ICU patients through a prospective, multi-aim design combining observational and randomized components. The study will be conducted in the medical intensive care unit (MICU), multidisciplinary critical care unit (MCCU), and cardiac care unit (CCU) at UAB.
Description
This study will evaluate the use of the Venous Excess Ultrasound (VExUS) score to guide fluid management in critically ill ICU patients through a prospective, multi-aim design combining observational and randomized components. The study will be conducted in the medical intensive care unit (MICU), multidisciplinary critical care unit (MCCU), and cardiac care unit (CCU) at UAB. Informed Arm: The treating team receives the patient's VExUS results and management recommendations. Not-Informed Arm: The treating team remains blinded to all VExUS findings and receives no feedback or recommendations.…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adults (≥18 years old) * Admitted to the MICU, MCCU, or CCU within 24 hours of admission * Acute kidney injury (AKI) (based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria) * Adequate acoustic windows for a complete VExUS scan Exclusion Criteria: * \< 18 years old * pregnant women * End-stage renal disease (ESRD) or prior renal transplant * Acute tubular necrosis (ATN) defined by urinalysis (≥2+ protein, ≥2+ blood, ≥1 muddy brown cast, ≥1 RBC cast, or ≥1 dysmorphic RBC)' * Prior Whipple procedures * currently incarcerated
Interventions
- OtherFluid Management
For patients in the informed arm, the overreader will generate standardized recommendations based on the VExUS score: VExUS = 0: Recommend a net positive fluid balance. VExUS = 1: Recommend a net neutral fluid balance. VExUS \>= 2: Recommend a net negative fluid balance. These recommendations will be communicated to the treating team via a structured process: documentation in the EHR under the POCUS note and verbal handoff to the resident, fellow, and attending on the primary team.
- OtherNo intervention
Primary team will not be informed about the patient's VExUS score and will not be given recommendations for fluid management
Location
- University of Alabama at Birmingham Medical CenterBirmingham, Alabama