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Background <p>Critically ill children are vulnerable to fluid overload due to complex fluid management. Early positive fluid balance may lead to systemic venous and pulmonary congestion, which can be challenging to detect clinically. Venous excess ultrasound (VExUS) and lung ultrasound (LUS) are emerging point-of-care tools to assess these complications. In adults, VExUS is classified into five grades (A–E) based on Doppler flow patterns. However, evidence on the use of VExUS, particularly in combination with LUS, in critically ill children with fluid overload is scarce, and their clinical utility in this setting is yet to be established.</p> Objectives <p>To evaluate the correlation between positive fluid balance and VExUS and LUS scores in critically ill children.</p> Methods <p>A cross-sectional study was conducted in the pediatric intensive care unit (PICU) of Dr. Cipto Mangunkusumo Hospital, from November to December 2024. The study included critically ill children aged 1 month to 18 years with a positive fluid balance within the first 24&#xa0;h of admission. Correlations between VExUS and LUS scores, fluid balance, and clinical signs were analyzed.</p> Results <p>In 40 critically ill children, there was no correlation between VExUS or LUS scores with positive fluid balance &gt; 5%. Additional results revealed a correlation between VExUS A and rhonchi (<i>r</i> = 0.367, <i>p</i> = 0.020), VExUS B and rhonchi (<i>r</i> = 0.367, <i>p</i> = 0.020), and VExUS D and edema (<i>r</i> = 0.328, <i>p</i> = 0.039).</p> Conclusion <p>VExUS and LUS scores were not significantly correlated with positive fluid balance. VExUS A, B, and D correlated with rhonchi and edema in critically ill children with fluid overload.</p>

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Correlation between positive fluid balances with venous excess ultrasound scores and lung ultrasound in critically ill children with fluid overload

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  • 发表日期：

    2025年10月24日

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  • Meita Dwi Utami,
  • Yogi Prawira,
  • Mulyadi M. Djer,
  • H.F. Wulandari,
  • Irene Yuniar,
  • Nastiti Kaswandani,
  • Jose M. Mandei

摘要

Background

Critically ill children are vulnerable to fluid overload due to complex fluid management. Early positive fluid balance may lead to systemic venous and pulmonary congestion, which can be challenging to detect clinically. Venous excess ultrasound (VExUS) and lung ultrasound (LUS) are emerging point-of-care tools to assess these complications. In adults, VExUS is classified into five grades (A–E) based on Doppler flow patterns. However, evidence on the use of VExUS, particularly in combination with LUS, in critically ill children with fluid overload is scarce, and their clinical utility in this setting is yet to be established.

Objectives

To evaluate the correlation between positive fluid balance and VExUS and LUS scores in critically ill children.

Methods

A cross-sectional study was conducted in the pediatric intensive care unit (PICU) of Dr. Cipto Mangunkusumo Hospital, from November to December 2024. The study included critically ill children aged 1 month to 18 years with a positive fluid balance within the first 24 h of admission. Correlations between VExUS and LUS scores, fluid balance, and clinical signs were analyzed.

Results

In 40 critically ill children, there was no correlation between VExUS or LUS scores with positive fluid balance > 5%. Additional results revealed a correlation between VExUS A and rhonchi (r = 0.367, p = 0.020), VExUS B and rhonchi (r = 0.367, p = 0.020), and VExUS D and edema (r = 0.328, p = 0.039).

Conclusion

VExUS and LUS scores were not significantly correlated with positive fluid balance. VExUS A, B, and D correlated with rhonchi and edema in critically ill children with fluid overload.