ClinicalTrials.gg
RecruitingNCT07805564Updated Sep 4, 2026

Evaluation of the Association Between the VEXUS Score and Hemodynamic Status and the Occurrence of Acute Kidney Injury After Open-Heart Surgery

An observational study in Acute Kidney Injury After Open Heart Surgery and Venous Congestion After Open Heart Surgery, sponsored by Hanoi Medical University. Recruiting at 1 site in Vietnam. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-04.

Sponsored by Hanoi Medical University · Observational

From the registry’s dates

  • Started Jan 2026; still recruiting 10 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
135
Ages
18 Years and older
Sex
All
01

Study summary

Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass and is associated with prolonged intensive care unit stay, increased morbidity, and mortality. Fluid overload and venous congestion are increasingly recognized as important contributors to postoperative organ dysfunction. The VExUS score is a bedside ultrasound tool that assesses systemic venous congestion through evaluation of the inferior vena cava and Doppler flow patterns in the hepatic, portal, and intrarenal veins. Although previous studies have suggested an association between VExUS-assessed venous congestion, AKI, and adverse outcomes, evidence regarding its relationship with advanced hemodynamic parameters remains limited. This prospective observational study will enroll adult patients undergoing cardiac surgery with cardiopulmonary bypass. All patients will undergo postoperative VExUS assessment and will be followed for the development of AKI and other postoperative complications. A predefined subgroup of patients undergoing clinically indicated PiCCO monitoring will additionally be evaluated to determine the association between VExUS score and PiCCO-derived hemodynamic parameters. The findings may support the use of VExUS as a noninvasive bedside tool for assessing venous congestion and identifying patients at increased risk of postoperative organ dysfunction after cardiac surgery.

Read the detailed description

Acute kidney injury remains a common complication after cardiac surgery with cardiopulmonary bypass and is associated with increased morbidity, mortality, and healthcare utilization. In addition to impaired cardiac output, growing evidence suggests that venous congestion plays an important role in the development of postoperative organ dysfunction. The VExUS score is an ultrasound-based tool that evaluates systemic venous congestion through assessment of the inferior vena cava and Doppler flow patterns in the hepatic, portal, and intrarenal veins. Previous studies have reported associations between venous congestion and adverse renal outcomes; however, data on the relationship between VExUS findings and advanced hemodynamic status in cardiac surgical patients remain limited.

This prospective observational study will be conducted in adult patients undergoing cardiac surgery with cardiopulmonary bypass. Postoperative VExUS assessments will be performed at predefined time points to evaluate the degree of venous congestion and its association with clinically relevant outcomes. All enrolled patients will be included in analyses examining the prognostic value of VExUS for postoperative AKI and other complications. In addition, a predefined subgroup of patients undergoing PiCCO monitoring as part of routine clinical care will be evaluated to investigate the relationship between VExUS scores and PiCCO-derived hemodynamic parameters.

The study aims to improve understanding of the role of venous congestion in postoperative organ dysfunction and to determine whether VExUS can serve as a practical noninvasive bedside tool for hemodynamic assessment and risk stratification following cardiac surgery.

02

Conditions studied

  • Acute Kidney Injury After Open Heart Surgery
  • Venous Congestion After Open Heart Surgery

Keywords

  • Acute Kidney Injury
  • Venous Congestion
  • Open heart surgery
  • PiCCO
03

In context

Acute Kidney Injury

1,691 studies on the registry are indexed under Acute Kidney Injury; 395 are open to participants now.

This study's planned enrollment of 135 is below the median of 160 across 814 observational studies indexed under Acute Kidney Injury.

Browse Acute Kidney Injury studies →

Lead sponsor

Hanoi Medical University is the lead sponsor of 54 studies on the registry; 17 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population consists of adult patients undergoing elective or emergency open heart surgery requiring cardiopulmonary bypass at Hanoi Medical University Hospital. Eligible patients will be admitted postoperatively to the Cardiac Surgical Intensive Care Unit and followed for the development of acute kidney injury and other postoperative complications

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult patients aged 18 years or older
  • Undergoing elective or emergent open-heart surgery with the use of Cardiopulmonary Bypass (CPB)

Exclusion criteria

Exclusion Criteria:

  • Severe tricuspid regurgitation End-stage chronic kidney disease (estimated below 15 mL per minute per 1.73 square meters)
  • Preoperative use of an intra-aortic balloon pump (IABP)
  • Preoperative use of extracorporeal membrane oxygenation (ECMO) or a ventricular assist device (VAD)
  • Liver cirrhosis, portal hypertension, or portal vein thrombosis
  • Refusal to participate by the patient or the patient's legally authorized representative
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
135 participants (estimated)
Patient registry
No

Groups and cohorts

  • Overall Cohort

    Adult patients undergoing cardiac surgery with cardiopulmonary bypass who receive postoperative VExUS assessment and follow-up for AKI and other postoperative complications

  • PiCCO Subgroup

    A subgroup of patients from the overall cohort who undergo PiCCO monitoring based on the clinical judgment of the treating physician. These patients will be included in analyses of the association between VExUS score and PiCCO-derived hemodynamic parameters

06

What researchers measure

Primary outcomes

  1. The correlation between the severity of systemic venous congestion, quantified by the VExUS grading system, and volumetric hemodynamic parameters (ELWI and GEDI)

    The severity of systemic venous congestion will be assessed using the Venous Excess Ultrasound (VExUS) grading system, which combines inferior vena cava measurements with Doppler flow assessments of the hepatic, portal, and intrarenal veins. Volumetric hemodynamic status will be evaluated using transpulmonary thermodilution monitoring (PiCCO), including extravascular lung water index (ELWI) and global end-diastolic volume index (GEDI). The association between VExUS grade and these hemodynamic parameters will be analyzed to determine whether increasing venous congestion is associated with greater intravascular volume loading and pulmonary fluid accumulation. VExUS and PiCCO measurements will be performed at predefined postoperative time points (T0, T4, T8, T12, T16, T20, T24, T30, T36, and T42 hours) and analyzed for correlation

    Time frame: Within the first 42 postoperative hours

  2. The prognostic value of VExUS for postoperative AKI

    Postoperative AKI will be defined and staged according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria based on changes in serum creatinine and urine output. VExUS assessments will be performed on postoperative Days 0, 1, and 2. The ability of VExUS scores and grades to predict the occurrence and severity of AKI will be evaluated according to KDIGO criteria

    Time frame: Within the first 7 postoperative days

Secondary outcomes

  1. The association between VExUS grades and dynamic indices of fluid responsiveness (SVV and PPV) to characterize the hemodynamic profile of fluid intolerance

    SVV and PPV will be measured using PiCCO monitoring at the same time points as VExUS assessment. Correlation analyses will evaluate the association between VExUS grades and dynamic indices of fluid responsiveness to characterize the hemodynamic profile of fluid intolerance. VExUS and PiCCO measurements will be performed at predefined postoperative time points (T0, T4, T8, T12, T16, T20, T24, T30, T36, and T42 hours) and analyzed for correlation

    Time frame: Within the first 42 postoperative hours

  2. Duration of mechanical ventilation

    Duration of mechanical ventilation will be defined as the time from postoperative ICU admission to successful extubation.

    Time frame: During hospitalization

  3. ICU length of stay

    ICU length of stay will be defined as the number of days from ICU admission to ICU discharge.

    Time frame: During hospitalization

  4. 30-day mortality

    Thirty-day mortality will be defined as all-cause death occurring within 30 days after cardiac surgery.

    Time frame: 30 days after surgery

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Rola P, Haycock K, Spiegel R, Beaubien-Souligny W, Denault A. VExUS: common misconceptions, clinical use and future directions. Ultrasound J. 2024 Nov 26;16(1):49. doi: 10.1186/s13089-024-00395-0. PubMed 39589643 ↗
  • Carsetti A, Antolini R, Domizi R, Damiani E, Adrario E, Donati A. Relationship between high VExUS score and echocardiographic parameters: a systematic review and meta-analysis. J Anesth Analg Crit Care. 2026 Jan 28;6(1):34. doi: 10.1186/s44158-026-00347-1. PubMed 41606663 ↗
  • Beaubien-Souligny W, Rola P, Haycock K, Bouchard J, Lamarche Y, Spiegel R, Denault AY. Quantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system. Ultrasound J. 2020 Apr 9;12(1):16. doi: 10.1186/s13089-020-00163-w. PubMed 32270297 ↗
  • Longino A, Martin K, Leyba K, Siegel G, Gill E, Douglas IS, Burke J. Correlation between the VExUS score and right atrial pressure: a pilot prospective observational study. Crit Care. 2023 May 26;27(1):205. doi: 10.1186/s13054-023-04471-0. PubMed 37237315 ↗

Individual participant data

Plan to share: No — Prohibited from laws (and/or rules, regulations, contracts); Need a consensus from colleagues

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07805564
Lead sponsor
Hanoi Medical University
Responsible party
Luu Xuan Vo (Principal Investigator, Hanoi Medical University) — Principal investigator
First posted
Sep 4, 2026
Start date
Jan 7, 2026
Primary completion
Sep 30, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Sep 4, 2026

Study contacts

Tu Nguyen Huu, Prof
Contact
nguyenhuutu@hmu.edu.vn
+84904176397
Minh Quang Pham, PhD
Contact
phamquangminh@hmu.edu.vn
+84912424932
Tu Huu Nguyen, Prof
study chair · Hanoi Medical University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion