Evaluation of the Venous Excess Ultrasound Score (VExUS) After Circulating Volume Modification in Children.

University Hospital, Toulouse67 enrolled

Overview

Venous overload has an impact on peripheral organ perfusion and on the short- and long-term prognosis of intensive care patients. The VExUS ultrasound score is a new tool whose parameters can be used to estimate this impact. This score was initially evaluated and validated on an adult population. ) In children, there is only one study looking at the use and applicability of this VExUS score, highlighting its feasibility in a paediatric population, as well as a possible correlation between elevated central venous pressure and altered renal Doppler (one of the score's components).

Study Type

OBSERVATIONAL

Enrollment

Conditions

Blood Volume Expansion

Interventions

VExUS evaluation ultrasoundOTHER

VExUS evaluation by ultrasound will be performed before the filling/bleeding/cleaning procedure, and again after the procedure: * Inferior vena cava measurement in Time-Motion (TM) mode, 1-2 cm from the right atrial orifice. * Hepatic venous Doppler measurement in pulsed Doppler mode. * Renal vein Doppler measurement in pulsed Doppler mode. Each measurement is performed three times consecutively (to average the results), then the ultrasound measurements are compiled into a score according to the degree of doppler severity.

Eligibility

Sex: ALLMin age: 1 YearMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Children aged between 1 and 18 years, receiving extrarenal purification with UF \> 10 ml/kg, bleeding \> 10 ml/kg or vascular filling \> 10 ml/kg Exclusion Criteria: * Refusal of the patient or opposition of one or both holders of parental authority. * Minors with parental authority. * Ultrafiltration time \> 6h. * Curarized patient, known abnormality of the hepatorenal venous network. * Patient agitated or poor tolerance of the examination. * Parents under court protection, guardianship or curatorship.

Outcomes

Primary Outcomes

Change in VExUS score

The correlation between ultrasound measurement of the VExUS score and the change in blood volume induced by extrarenal purification, bloodletting or vascular filling is studied. Ultrasound is performed before and after the procedure, each measure 3 times in succession, to establish the score.

Time frame: 10 minutes before en after the procedure of extrarenal purification, bloodletting or vascular filling