VExUS-Guided Fluid Management for Acute Kidney Injury

(VExUS Trial)

TI
SF
Overseen BySteve Fox, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Alabama at Birmingham

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method for managing fluids in critically ill patients with acute kidney injury (AKI). Researchers aim to determine if a special ultrasound score, called VExUS, can assist doctors in making better fluid treatment decisions. Participants are divided into two groups: one where doctors have access to VExUS results and one where they do not. Adults with AKI admitted to certain intensive care units within the last 24 hours may qualify for this study. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance fluid management in critical care.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the VExUS-guided fluid management is safe for critically ill ICU patients?

Research has shown that the Venous Excess Ultrasound (VExUS) score can aid in managing fluids in ICU patients. Studies have examined whether VExUS can help control fluid levels in patients with acute kidney injury (AKI). In these studies, patients generally tolerated VExUS-guided treatment well.

Previous research has not identified significant safety issues. No major negative effects specifically linked to VExUS-guided management were reported, suggesting the treatment may be safe for critically ill patients. However, individual responses can vary.

The current trial phase is labeled as "Not Applicable," indicating early research stages. The absence of major negative effects in earlier studies provides some reassurance about safety. Prospective participants should consult their healthcare provider for personalized advice.12345

Why are researchers excited about this trial?

Researchers are excited about the VExUS-guided fluid management approach for acute kidney injury because it offers a personalized and targeted way to manage fluids based on an ultrasound assessment of the veins. Unlike traditional methods that rely on more generalized fluid management techniques, this method uses the VExUS (venous excess ultrasound) score to tailor treatment to the individual patient's needs. This could potentially lead to more precise interventions, reducing the risk of fluid overload and improving kidney outcomes.

What evidence suggests that VExUS-guided fluid management is effective for acute kidney injury?

Research has shown that the Venous Excess Ultrasound (VExUS) score can help manage fluids in ICU patients with acute kidney injury (AKI). Studies have found that VExUS can guide fluid administration, which is crucial for effective treatment. In this trial, participants in the "Informed" arm will have their fluid management guided by VExUS results and recommendations. One study found that using VExUS for fluid management led to better fluid control and possibly improved outcomes in complicated AKI cases. Another study noted that higher VExUS scores were linked to lower survival rates, indicating that the score can help identify patients at higher risk. Overall, using VExUS to guide fluid management appears promising for improving care in seriously ill patients with kidney problems.15678

Are You a Good Fit for This Trial?

This trial is for critically ill ICU patients who may have acute kidney injury. It's being conducted in various critical care units at UAB. Specific eligibility criteria are not provided, but typically participants would need to be stable enough to undergo the interventions without significant risk of immediate deterioration.

Inclusion Criteria

Admitted to the MICU, MCCU, or CCU within 24 hours of admission
Acute kidney injury (AKI) based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria
I can undergo a complete VExUS scan without issues.
See 1 more

Exclusion Criteria

I have end-stage kidney disease or have had a kidney transplant.
Acute tubular necrosis (ATN) defined by urinalysis (≥2+ protein, ≥2+ blood, ≥1 muddy brown cast, ≥1 RBC cast, or ≥1 dysmorphic RBC)
I am under 18 years old.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Enrollment and Initial Assessment

Participants undergo two VExUS ultrasound assessments to assess waveform reliability and inter-user reproducibility

Immediate upon enrollment
1 visit (in-person)

Follow-up Assessment

A single VExUS scan is performed 48-72 hours after enrollment along with concurrent collection of serum creatinine, intake/output balance, and renal replacement therapy status

48-72 hours after enrollment
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with primary outcomes measured up to 30 days

up to 30 days

What Are the Treatments Tested in This Trial?

Interventions

  • VExUS-guided Fluid Management

Trial Overview

The study tests if using the Venous Excess Ultrasound (VExUS) score to guide fluid management can benefit ICU patients with potential kidney issues. Some will receive tailored fluid management based on VExUS scores, while others won't get this intervention.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Placebo Group

Group I: InformedExperimental Treatment1 Intervention
Group II: Non-informedPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials
1,677
Recruited
2,458,000+

Citations

VExUS-guided Fluid Management in Patients With Acute ...

This quasi-experimental study aims to verify whether the incorporation of VExUS in patients with AKI in the Intensive Care Unit (ICU) may prompt tailored ...

Venous Excess Ultrasound for Fluid Assessment in Complex ...

The aim of the current study was to determine whether venous excess ultrasound can help guide fluid therapy in complex patients with acute kidney injury (AKI)

NCT07291778 | VExUS-guided Fluid Management in the ICU

This study will evaluate the use of the Venous Excess Ultrasound (VExUS) score to guide fluid management in critically ill ICU patients ...

The VExUS score and mortality in patients with Acute ...

However, VExUS grades 2-3 were associated with lower survival rates in the cardiore- nal subgroup and patients with AKI grade 1. Keywords: acute kidney injury; ...

Venous excess ultrasound score-guided fluid resuscitation ...

This study aims to compare the effect of fluid resuscitation based on the surviving sepsis campaign recommendations (SSC) versus fluid ...

Association between the Venous Excess Ultrasound (VExUS ...

The primary outcome was the prevalence of acute kidney injury (AKI) during ICU stay, while secondary outcomes included 30-day mortality, ICU ...

VExUS Score in the Management of Patients With Acute ...

The aim of this study is to verify whether the VExUS score can serve as a guide to decongestion in patients with severe AKI.

Prospective Study of Ultrasound Markers of Organ ...

We calculated the venous excess ultrasound (VExUS) score based on these data. The primary outcome studied was major adverse kidney events at 30 ...