Doppler identified venous congestion in septic shock: protocol for an international, multi-centre prospective cohort study (Andromeda-VEXUS)

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dc.contributor.authorPrager, Ross
dc.contributor.authorArgaiz, Eduardo
dc.contributor.authorPratte, Michael
dc.contributor.authorRola, Philippe
dc.contributor.authorArntfield, Robert
dc.contributor.authorBeaubien-Souligny, William
dc.contributor.authorDenault, Andre Y.
dc.contributor.authorHaycock, Korbin
dc.contributor.authorAguiar, Francisco Miralles
dc.contributor.authorBakker, Jan
dc.contributor.authorOspina-Tascon, Gustavo
dc.contributor.authorOrozco, Nicolas
dc.contributor.authorRochwerg, Bram
dc.contributor.authorLewis, Kimberley
dc.contributor.authorQuazi, Ibrahim
dc.contributor.authorKattan, Eduardo
dc.contributor.authorHernandez, Glenn
dc.contributor.authorBasmaji, John
dc.date.accessioned2025-01-20T17:37:54Z
dc.date.available2025-01-20T17:37:54Z
dc.date.issued2023
dc.description.abstractIntroduction Venous congestion is a pathophysiological state where high venous pressures cause organ oedema and dysfunction. Venous congestion is associated with worse outcomes, particularly acute kidney injury (AKI), for critically ill patients. Venous congestion can be measured by Doppler ultrasound at the bedside through interrogation of the inferior vena cava (IVC), hepatic vein (HV), portal vein (PV) and intrarenal veins (IRV). The objective of this study is to quantify the association between Doppler identified venous congestion and the need for renal replacement therapy (RRT) or death for patients with septic shock.Methods and analysis This study is a prespecified substudy of the ANDROMEDA-SHOCK 2 (AS-2) randomised control trial (RCT) assessing haemodynamic resuscitation in septic shock and will enrol at least 350 patients across multiple sites. We will include adult patients within 4 hours of fulfilling septic shock definition according to Sepsis-3 consensus conference. Using Doppler ultrasound, physicians will interrogate the IVC, HV, PV and IRV 6-12 hours after randomisation. Study investigators will provide web-based educational sessions to ultrasound operators and adjudicate image acquisition and interpretation. The primary outcome will be RRT or death within 28 days of septic shock. We will assess the hazard of RRT or death as a function of venous congestion using a Cox proportional hazards model. Sub-distribution HRs will describe the hazard of RRT given the competing risk of death.Ethics and dissemination We obtained ethics approval for the AS-2 RCT, including this observational substudy, from local ethics boards at all participating sites. We will report the findings of this study through open-access publication, presentation at international conferences, a coordinated dissemination strategy by investigators through social media, and an open-access workshop series in multiple languages.Trial registration number NCT05057611.
dc.fuente.origenWOS
dc.identifier.doi10.1136/bmjopen-2023-074843
dc.identifier.issn2044-6055
dc.identifier.urihttps://doi.org/10.1136/bmjopen-2023-074843
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/91698
dc.identifier.wosidWOS:001062674600011
dc.issue.numero7
dc.language.isoen
dc.revistaBmj open
dc.rightsacceso restringido
dc.subjectdiagnostic imaging
dc.subjectinfectious diseases
dc.subjectadult intensive & critical care
dc.subjectacute renal failure
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDoppler identified venous congestion in septic shock: protocol for an international, multi-centre prospective cohort study (Andromeda-VEXUS)
dc.typeartículo
dc.volumen13
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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