The hypothesis is that fluid-responsive patients who show signs of venous congestion experience a worsening of microcirculatory status after fluid administration compared to patients without signs of venous congestion
Critically ill patients admitted to the intensive care unit
Invasive or minimally invasive hemodynamic monitoring
Suspected or confirmed pregnancy
Inability to access the oral cavity (e.g., facial trauma, oral bleeding)
Critically ill patients admitted to the intensive care unit
Cohort
Prospective
fluid challenge
DrugSigns of venous congestion and microcirculatory status will be assessed at baseline. A fluid challenge will then be performed, and microcirculation will be evaluated at the end of fluid administration and again after 30 minutes
Change in Sublingual total vessel density (TVD)
To compare changes in sublingual microcirculatory parameter - total vessel density (TVD) - before fluid administration, immediately after volume expansion, and 30 minutes post-fluid administration in preload-dependent patients with and without signs of venous congestion.
Change in Sublingual percentage of perfused vessels (PPV)
To compare changes in sublingual microcirculatory parameter - percentage of perfused vessels (PPV) - before fluid administration, immediately after volume expansion, and 30 minutes post-fluid administration in preload-dependent patients with and without signs of venous congestion.
Change in Sublingual Microcirculatory Flow Index (MFI)
The primary objective of the study is to compare changes in sublingual microcirculation, measured by the Microcirculatory Flow Index (MFI), before fluid administration, immediately after volume expansion, and 30 minutes post-fluid administration in preload-dependent patients with and without signs of venous congestion.
Change in Sublingual perfused vessel density (PVD)
To compare changes in sublingual microcirculatory parameters - perfused vessel density (PVD) - before fluid administration, immediately after volume expansion, and 30 minutes post-fluid administration in preload-dependent patients with and without signs of venous congestion.
Change in Sublingual microcirculatory heterogeneity index (MHI)
To compare changes in sublingual microcirculatory parameters - microcirculatory heterogeneity index (MHI) - before fluid administration, immediately after volume expansion, and 30 minutes post-fluid administration in preload-dependent patients with and without signs of venous congestion.
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