Indice di pulsatilixtà della vena porta per valutare la congestione venosa sistemica dopo fluid challenge in pazienti inizialmente precarico dipendenti e fluid tolerant dopo chirurgia cardiaca

This prospective observational study uses the portal vein pulsatility index (PVPI) to assess fluid intolerance in initially fluid responder and fluid tolerant patients after cardiac surgery. The study population is composed by mechanically ventilated patients within 6 hours after ICU admission following cardiac surgery who are considered for fluid administration to optimize hemodynamics undergo a Passive Leg Raising (PLR) test and Left Ventricular Outflow Tract (LVOT) recording using transthoracic echocardiography (TTE). The main objective of the study is to predict fluid intolerance (PVPI ≥ 50%) after fluid challenge (7 ml/kg ml Ringer Lactate given in 10 min) amongst initially tolerant (patients who have a baseline venous flow pulsatility index < 50%) fluid responders (patients who have ΔLVOT-VTI ≥ 12% after the PLR test) by using the post-PLR PVPI. The secondary objectives are to describe the incidence of and the hemodynamic factors associated with fluid intolerance at baseline in postoperative cardiac surgery patients needing cardiocirculatory support (i.e., patients with baseline PVPI < 50% vs. patients with baseline PVPI ≥ 50%).