Prognostic Power of the VEXUS Score in Septic Shock: Effectiveness in Mortality Prediction
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Serial VEXUS Ultrasound Evaluation.
- Who it may be relevant to
- Registry conditions: Septic Shock, VExUS. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Prognostic Power of the VEXUS Score in Septic Shock: Efficacy in Mortality Prediction
Overview
This study aims to evaluate the prognostic power of the VEXUS Score in predicting mortality among patients with septic shock in intensive care units.
Detailed description
After the diagnosis of septic shock, patients will be assessed for eligibility. Following informed consent, measurements will be taken within the first 4 hours of shock onset, and treatment (inotropic and vasopressor doses, fluid challenge, corticosteroids) will be recorded. A second measurement will occur between 12 and 24 hours, and a third at 72 hours. All treatment and care protocols will be managed according to routine unit protocols.
Data will be systematically collected at three time points (0-4 hours, 12-24 hours, and 72 hours). These will include hemodynamic parameters, laboratory tests (including infection markers), need for renal replacement therapy, mechanical ventilation requirement and duration, cumulative dose and duration of vasopressor use, ICU stay, and survival status.
VEXUS Score Grading
The VEXUS score will be graded as follows:
* Grade 0 (No Congestion): No signs of venous congestion are detected. The inferior vena cava (IVC) diameter is less than 2 cm. * Grade 1 (Mild Venous Congestion): The IVC diameter is 2 cm or greater. However, hepatic, portal, or renal vein flow measurements exhibit normal waveform patterns, or only one mildly abnormal waveform pattern is present. * Grade 2 (Moderate Venous Congestion): The IVC diameter is 2 cm or greater. Additionally, analysis of hepatic, portal, or renal vein waveforms reveals one severe congestion finding. * Grade 3 (Severe Venous Congestion): The IVC diameter is 2 cm or greater. Furthermore, analysis of hepatic, portal, or renal vein waveforms shows two or more severe congestion findings.
Data will be analyzed using SPSS version 23.0, with normality assessed through visual and analytical methods (Kolmogorov-Smirnov/Shapiro-Wilk tests). Continuous variables will be compared using t-tests or Mann-Whitney U tests, and categorical variables using Chi-square tests. ROC analysis will be used to assess the predictive value of VEXUS for mortality.
Interventions
- Diagnostic test Serial VEXUS Ultrasound Evaluation
Ultrasound assessments will be performed by an experienced anesthesiologist at three time points (0-4 hours, 12-24 hours, and 72 hours)to determine the degree of venous congestion using the VEXUS Score. No treatment changes will be made based on the VEXUS findings. The scores will solely be used for prognostic correlation with mortality outcomes.
Primary outcome measures
- 28-day intensive care unit mortality in relation to VEXUS score [Time frame: Up to 28 days following intensive care unit admission.]
Secondary outcome measures (4)
- Need for mechanical ventilation in relation to VEXUS score [Time frame: Within the first 72 hours of intensive care unit admission.]
- Duration of mechanical ventilation in relation to VEXUS score. [Time frame: From intensive care unit patients admission until extubation, up to 28 days.]
- Length of intensive care unit stay in relation to VEXUS score [Time frame: From intensive care unit admission until intensive care unit discharge, up to 28 days.]
- Vasopressor dose and duration in relation to VEXUS score. [Time frame: First 72 hours after intensive care unit admission]
Eligibility criteria
Inclusion criteria
- Age>18
- Patients monitored for septic shock in intensive care unit
- Signed informed consent
Exclusion criteria
- Age <18
- Severe obesity precluding adequate ultrasonographic imaging.
- Patients in whom venous structures cannot be clearly assessed via ultrasonography due to anatomical or technical reasons (e.g., adhesions following abdominal surgery).
- Patients receiving dialysis due to chronic kidney disease or initiating dialysis for acute kidney failure.
- Chronic heart failure.
- Patients with advanced valvular insufficiency or advanced pulmonary hypertension.
- Patients with portal hypertension or advanced-stage liver cirrhosis.
- Presence of acute or chronic thrombosis in the inferior vena cava or other venous structures within the scoring area.
- Refusal to participate
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07124741 · 2024-435