• J. Cardiothorac. Vasc. Anesth. · Jun 2024

    Multicenter Study Observational Study

    Pulsatile Femoral Vein Doppler Pattern is a Parameter of Venous Congestion in ICU Patients.

    • Stefan Andrei, Pierre-Alain Bahr, Marine Alissant, Melissa Saccu, Maxime Nguyen, Bogdan A Popescu, Belaid Bouhemad, and Pierre-Grégoire Guinot.
    • Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania. Electronic address: stefanmandrei@gmail.com.
    • J. Cardiothorac. Vasc. Anesth. 2024 Jun 1; 38 (6): 136113681361-1368.

    ObjectivesThe aim of this study was to evaluate if the presence of a pulsatile femoral vein pattern is an indicator of venous congestion in the intensive care unit (ICU).DesignRetrospective observational study.SettingThree medico-surgical university-affiliated ICUs.ParticipantsAdult patients who had an ultrasound evaluation at several time points during their ICU stay: at baseline (within 24 hours of admission to ICU), daily during their ICU stay, and within 24 hours before ICU discharge.InterventionsAt each time point, the hemodynamic, respiratory, and cardiac ultrasound parameters were recorded. The common femoral vein was studied with pulsed-wave Doppler at the level of the femoral trigonum, with high frequency (5-13 MHz) linear array vascular probe and venous vascular mode, in supine patients.Measurements And Main ResultsOne hundred eight patients who underwent 400 ultrasound evaluations (3.7 ± 1 ultrasound evaluations per patient) during their ICU stay were included. Seventy-nine of 108 patients (73%) had a pulsatile femoral vein pattern at least at 1 time point. The multivariable mixed effects logistic regression model demonstrated an association among pulsatile femoral vein pattern, body mass index (OR: 0.91[95% CI 0.85-0.96], p = 0.002), inferior vena cava mean diameter (OR: 2.35 [95% CI 1.18-4.66], p = 0.014), portal vein pulsatility (OR: 2.3 [95% CI 1.2-4.4], p = 0.012), and congestive renal vein flow pattern (OR: 4.02 [95% CI 2.01-8.03], p < 0.001). The results were confirmed by principal component analysis.ConclusionIn the ICU, a pulsatile femoral vein pattern is associated with parameters of venous congestion, independently of the patient's volume status, and ventilatory treatment. These results suggest the femoral vein Doppler pulsatility as a parameter of congestion in ICU patients.Copyright © 2023 Elsevier Inc. All rights reserved.

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