VENOUS CONGESTION IN SEPTIC SHOCK: A SYSTEMATIC REVIEW AND PILOT STUDY

Abstract

This thesis consists of two related studies presented as separate manuscripts. This research focuses on understanding venous congestion in critically ill patients. First, we conducted a systematic review to summarize evidence regarding venous congestion in critically ill patients, particularly those with septic shock, to understand its association with organ dysfunction and outcomes. We included observational studies that used the Venous Excess Ultrasound (VeXUS) score in critically ill patients. Following the systematic review, we performed a retrospective analysis of a previously conducted pilot study to assess the velocity time integral (VTI)-VeXUS ratio, a novel hemodynamic marker that we propose, to better understand integrated hemodynamic measurements that consider both arterial and venous physiology. Despite advances in sepsis management, venous congestion remains an under-recognized component of shock. This thesis contributes to the growing body of evidence advocating for a more nuanced approach to resuscitating patients with septic shock.