Prospective Evaluation of Venous Congestion Using the Venous Excess Ultrasound Score (Vexus) During Early Fluid Resuscitation in Adult Patients With Major Burns
Research Study on Venous Congestion in Burn Patients Using Ultrasound
Sunnie Wong
Primary Investigator
Brief description of study
This study aims to prospectively characterize venous congestion during early burn resuscitation by use of ultrasound and evaluate its relationship to traditional resuscitation metrics.
Detailed description of study
Prospective, observational cohort study. No randomization. No intervention beyond noninvasive ultrasound examinations. VExUS will not be used to guide clinical care.
VExUS Ultrasound Assessment Performed at 0, 6, 12, 18, and 24 hours. Each exam includes:
● IVC diameter and respiratory variation
● Hepatic vein Doppler waveform
● Portal vein pulsatility
● Renal venous Doppler waveform
Images will be stored per institutional ultrasound archiving policy.
Data will be collected from the electronic medical record:
● Vital signs (HR, MAP)
● Vasopressor dose (norepinephrine equivalent)
● Urine output (mL/hr and mL/kg/hr over preceding 6 hours)
● Fluid administration (interval and cumulative)
● Laboratory values (lactate, bicarbonate/base deficit, creatinine, BUN)
No study-specific blood draws will be required.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Major burns, TBSA burn
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Age: 18 years - 100 years
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Gender: All
Inclusion Criteria
● Age ≥18 years
● ≥20% TBSA burn OR initiation of formal burn resuscitation protocol
● Admission to ICU or monitored setting
● Enrollment within 6 hours of initiation of resuscitation
Exclusion Criteria
● Pregnancy
● Prisoners
● Comfort-measures-only status
● Inability to obtain adequate ultrasound windows after reasonable attempt
The purpose of this study is to investigate the use of the Venous Excess Ultrasound Score (VExUS) in evaluating venous congestion in adult patients with major burns. Venous congestion refers to the accumulation of blood in the veins, which can occur during fluid resuscitation, a process where fluids are given to patients to replace lost blood and fluids.
In this study, the researchers will use ultrasound, a test that uses sound waves to create images of the inside of the body, to measure the VExUS grade. They will look at how this grade relates to the amount of fluids given to patients, their need for medications that help the heart pump blood, and any differences between urine output and signs of congestion in the body.
- Who can participate: Participants must be adults with major burns. Additional eligibility criteria include the ability to undergo ultrasound procedures and receive fluid resuscitation.
- Study details: Participants will undergo ultrasound assessments to measure venous congestion during fluid resuscitation. The study will focus on understanding the relationship between ultrasound findings and fluid management.
