Scholarlink

Background <p>Sepsis and septic shock are life-threatening conditions driven by dysregulated host responses to infection, resulting in multi-organ dysfunction. While early fluid resuscitation is essential, both fluid overload and under-resuscitation can worsen outcomes. Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) has emerged as a non-invasive echocardiographic tool to assess fluid responsiveness. This systematic review evaluates the diagnostic performance, cutoff values, and limitations of LVOT VTI as a tool for assessing fluid responsiveness in adult patients with sepsis or septic shock.</p> Methods <p>A systematic search of PubMed, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL was conducted through April 13, 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251036927). Eligible studies used transthoracic or transesophageal echocardiography to measure LVOT VTI and assessed changes following passive leg raise (PLR) or volume expansion tests (VET). Fluid responsiveness was defined as a ≥ 10–15% increase in VTI.</p> Results <p>Three observational studies including 199 adult patients (20 with sepsis, 179 with septic shock) met inclusion criteria. Two studies used VET (500 mL saline), and one used PLR. Optimal LVOT VTI cutoffs ranged from &gt; 7% to 16%, with sensitivity 78–96%, specificity 91–100%, and AUCs 0.84–0.99. Based on the Newcastle–Ottawa Scale, two studies were rated good quality, and one was fair.</p> Conclusion <p>LVOT VTI is a reliable, non-invasive parameter for assessing fluid responsiveness in sepsis and septic shock. Despite limited data, this review supports its integration into bedside fluid management protocols to guide individualized resuscitation strategies.</p> PROSPERO Registration ID <p>CRD420251036927.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Utilization of left ventricular outflow tract velocity time integral in the assessment of fluid responsiveness in adult patients with sepsis or septic shock – a systematic review

  • 期刊论文

  • 发表日期：

    2025年8月23日

查看全文
  • Stephin Zachariah Saji,
  • Olivia Murga,
  • Swati Khurana,
  • Bui Hung Phan,
  • Bana Khalil,
  • Amina Mustafa Nagra,
  • Steysi Falcon Aragon,
  • Deekksha Kolagatla,
  • Victor Sebastian Arruarana,
  • Domenica A. Herrera,
  • Samer Kottiech,
  • Ernesto Calderón Martínez

摘要

Background

Sepsis and septic shock are life-threatening conditions driven by dysregulated host responses to infection, resulting in multi-organ dysfunction. While early fluid resuscitation is essential, both fluid overload and under-resuscitation can worsen outcomes. Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) has emerged as a non-invasive echocardiographic tool to assess fluid responsiveness. This systematic review evaluates the diagnostic performance, cutoff values, and limitations of LVOT VTI as a tool for assessing fluid responsiveness in adult patients with sepsis or septic shock.

Methods

A systematic search of PubMed, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL was conducted through April 13, 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251036927). Eligible studies used transthoracic or transesophageal echocardiography to measure LVOT VTI and assessed changes following passive leg raise (PLR) or volume expansion tests (VET). Fluid responsiveness was defined as a ≥ 10–15% increase in VTI.

Results

Three observational studies including 199 adult patients (20 with sepsis, 179 with septic shock) met inclusion criteria. Two studies used VET (500 mL saline), and one used PLR. Optimal LVOT VTI cutoffs ranged from > 7% to 16%, with sensitivity 78–96%, specificity 91–100%, and AUCs 0.84–0.99. Based on the Newcastle–Ottawa Scale, two studies were rated good quality, and one was fair.

Conclusion

LVOT VTI is a reliable, non-invasive parameter for assessing fluid responsiveness in sepsis and septic shock. Despite limited data, this review supports its integration into bedside fluid management protocols to guide individualized resuscitation strategies.

PROSPERO Registration ID

CRD420251036927.

Graphical abstract