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Updated: Mar 11, 2026

Ultrasonographic Assessment During Cardiopulmonary Resuscitation
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Deresuscitation Informed by Ultrasound in Patients With Septic Shock Trial: A Pilot Randomized Controlled Study.

Brendan Innes1, Christopher Allison2, Nicholas Seidler3

  • 1Department of Emergency Medicine, Division of Emergency Critical Care, Stanford University School of Medicine, Palo Alto, California, USA.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|March 10, 2026
PubMed
Summary

Point-of-care venous excess ultrasound (VExUS) is a feasible method for guiding fluid management in septic shock patients. This approach may help reduce fluid administration without increasing adverse events.

Keywords:
deresuscitationpilot randomized controlled feasibility trialseptic shockvenous excess ultrasound (VExUS)

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Area of Science:

  • Critical Care Medicine
  • Point-of-Care Ultrasound
  • Hemodynamic Monitoring

Background:

  • Septic shock management requires careful fluid resuscitation and deresuscitation.
  • Venous congestion is a key indicator of fluid overload.
  • Point-of-care ultrasound offers a method for real-time assessment.

Purpose of the Study:

  • To assess the feasibility of venous excess ultrasound (VExUS)-guided fluid management in adult septic shock patients.
  • To determine if VExUS guidance can individualize fluid resuscitation and deresuscitation.
  • To evaluate the safety and potential impact on fluid balance.

Main Methods:

  • Pilot randomized controlled feasibility trial.
  • Adult patients with septic shock randomized to VExUS-guided or usual care.
  • Daily VExUS ultrasounds with fluid management recommendations for the intervention arm.

Main Results:

  • 19 participants enrolled; 12 randomized to VExUS arm.
  • VExUS arm had a lower intervention period fluid balance (-65 mL vs 2608 mL).
  • No significant differences in acute kidney injury, respiratory failure, or mortality; rates were lower in VExUS arm.

Conclusions:

  • VExUS-guided fluid management is feasible in septic shock.
  • The approach was not associated with increased adverse events.
  • VExUS guidance may reduce the volume of fluids administered in septic shock.