This study is a prospective observational cohort study conducted planned to include 40 patients with ARDS to assess the effect of different levels of PEEP titration on VExUS score and renal outcomes in patients with Acute Respiratory Distress Syndrome.
Age ≥18 years.
Diagnosis of ARDS according to the Berlin criteria.
Invasive mechanical ventilation ≥24 hours.
Requirement of PEEP ≥5 cmH₂O.
Known end-stage renal disease on chronic dialysis.
History of renal transplantation.
Pregnancy.
Known severe tricuspid regurgitation.
patients with ARDS within 24 hours of onset and mechanically ventilated for more than 24 hours.
Cohort
Prospective
VExUS score
Other interventionThe Venous Excess Ultrasound Score (VExUS) was calculated for each patient based on the assessment of systemic venous congestion using the following parameters: Inferior vena cava (IVC) diameter and respiratory collapsibility, Hepatic vein Doppler waveform, Portal vein Doppler pulsatility and Intrarenal venous Doppler pattern.
VExUS score
Change in VExUS score in relation to different PEEP levels in mechanically ventilated patients with ARDS.
Development of acute kidney injury (AKI)
Development of acute kidney injury (AKI), defined and staged according to the KDIGO criteria: increase in serum creatinine by ≥0.3 mg/dL within 48 hours, or ≥1.5 times baseline within 7 days, or urine output \<0.5 mL/kg/hour for 6 hours.
Requirement for renal replacement therapy (RRT) during ICU stay.
Requirement for renal replacement therapy (RRT) during ICU stay.
Length of ICU stay
Length of ICU stay
ICU mortality
ICU mortality during ICU Stay
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