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Título

Venous Excess Ultrasound Score Association with Acute Kidney Injury in Critically Ill Patients: A Systematic Review and Meta-Analysis

Descrição do caso

Background: Systemic venous congestion assessed by the venous excess ultrasound score (VExUS), has been associated with acute kidney injury (AKI) in patients undergoing cardiac surgery. However, there is a lack of evidence of this association in the general critically ill patients populations.
Study Design and Methods: PubMed, Embase, and Cochrane databases were searched for observational prospective studies that included critically ill patient and analyzed VExUS score on the first day of admission to the ICU. Venous congestion was defined as VExUS >2. The main outcome was occurrence of AKI. Secondary outcome was all-cause mortality. Statistical analysis was performed using Review Manager 5.4.1. Odds ratios (OR) with 95% confidence interval were pooled using a random-effects model.
Results: Our analysis included 1036 patients from nine studies, of whom 17.4% presented venous congestions according to VExUS definition. In critically ill patients presenting with venous congestion (VExUS score > 2), the incidence of AKI was significantly higher as compared with those without congestion (OR 2.43, 95% CI, 1.13–5.20; p = 0.02). Compared to non-cardiac cases, the association was notably stronger in cardiac surgery patients (OR 3.86, 95% CI, 2.32–6.42; p < 0.00001). There was no significant association between venous congestion and all-cause mortality (OR 1.25, 95% CI, 0.71–2.19; p = 0.44).Interpretation: VExUS score was associated with an increased incidence of AKI in critically ill patients, particulary in the subgroup of cardiac surgery patients.No association was found between VExUS score and all-cause mortality.