ASSESSMENT OF VENOUS FLUID OVERLOAD BY ULTRASOUND IN PATIENTS WITH ACUTE HEART FAILURE IN THE INTENSIVE CARE UNIT OF DA NANG HOSPITAL
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Abstract
Objectives: To investigate the characteristics of systemic venous congestion assessed by VExUS in patients with acute heart failure, and to evaluate the association between VExUS scores and in-hospital mortality.
Subjects: 63 acute heart failure patients (diagnosed according to the 2021 ESC guidelines) admitted to the ICU at Da Nang Hospital from June 2023 to June 2024.
Methods: A prospective, descriptive study.
Results: The mean age was 73 ± 14 years, with males accounting for 60.3%. The overall mortality rate was 12.7% (8 patients). Venous congestion on admission was prevalent at 80.9%; notably, it was 100% in the non-survivor group with a mean VExUS score of 2.88 ± 0.3 (compared to 1,35 ± 0.9 in the survivor group; p < 0.001). Patients with a VExUS score of 3 had a mortality rate of up to 50%. The admission VExUS score demonstrated strong prognostic value for mortality, with an AUC of 0.909 at a cut-off value of 2.5 (sensitivity 87.5%, specificity 87.3%). Changes in VExUS scores and lung ultrasound (LUS) findings were strongly and positively correlated with a negative cumulative fluid balance (p < 0.05). Multivariable regression analysis confirmed that an admission VExUS score of 3 was an independent predictor of mortality (p < 0.05).
Conclusions: Systemic venous congestion is highly prevalent among patients with acute heart failure in the ICU. An admission VExUS score of 3 serves as a strong, independent predictor of in-hospital mortality, helping to optimize fluid management and diuretic therapy protocols in clinical practice.
Keywords
VExUS, venous congestion, acute heart failure, intensive care
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References
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