Fluid Challenge Impact in the Portal Vein Pulsatility Depending on the Fluid Responsivness Status

Fluid Challenge Impact in the Portal Vein Pulsatility Depending on the Fluid Responsivness Status

Portal vein pulsatility index is a marker of venous congestion evaluated by point of care ultrasound. It is associated with acute kidney injury, especially in critically ill patients. It may be considered as a dynamic marker. The investigators hypothesized that portal vein pulsatility index is higher after a fluid challenge only in patient without preload dependence in critically ill patients with cardiovascular insufficiency.

Inclusion Criteria:

• vasopressor requirement to maintain mean arterial pressure >65mmHg AND

• at least one of the following criteria:

  • arterial lactate >2mmol/L;
  • capillary refill time >3s;
  • mottling score >1;
  • diuresis <0,5mL/h for more than 6hours.

Exclusion Criteria:

• Diameter of vena cava <20mm
• Cirrhosis
• Pregnancy
• Severe acute pulmonary edema
• Phototype 4 or 5
• Patient opposition to participate