USE OF POINT-OF-CARE ULTRASOUND (POCUS) IN THE ASSESSMENT OF FLUID RESPONSIVENESS: PRACTICAL APPLICATIONS AND METHODS

Authors

  • Luan Caimar Fuchs Author
  • Bruna Turra Aimi Author
  • Felipe Romão Hatisuka Author
  • José Henrique Gorgone Zampieri Author
  • Jaime Javier Garcia Caro Author
  • Kelen Marques de Souza Author
  • Lucas Braun Gonçalves Author
  • João Marcello Fernandes Zanata Author
  • Júnior Girardi Author
  • Maria Eduarda Faraldo Calore Author
  • Filippo Fabi Bez Author
  • Adriano Pereira Rocha Author
  • Bráulio Queiros de Andrade Author
  • Luís Otávio Garcia de Oliveira Author
  • Lucas Marcos Balduino Author
  • Débora Vieira de Melo Agra Duarte Nunes Author
  • Lara Cristine Quaresma Oliveira Author
  • João Vicente Soares Martins Author
  • Emily Carboni Silveira Neto Author
  • Rafael de Cristo Author
  • Giulia Regina Frangiotti Author
  • Gabriela Zanardo Sousa Author

DOI:

https://doi.org/10.56238/levv17n59-044

Keywords:

Point-Of-Care Ultrasound, Fluid Responsiveness, Hemodynamic Monitoring, Critical Care, Echocardiography

Abstract

Fluid responsiveness assessment is essential in the management of critically ill patients, as inappropriate fluid administration is associated with adverse outcomes. In this context, point-of-care ultrasound (POCUS) has emerged as a key tool for hemodynamic monitoring, enabling dynamic bedside evaluation. This study is a structured critical narrative review analyzing 18 studies published between 2015 and 2025, identified through PubMed/MEDLINE, Scopus, and Web of Science databases. Ultrasound-based methods evaluated included left ventricular outflow tract velocity-time integral (LVOT VTI), passive leg raising (PLR), and indices derived from the inferior and superior vena cava. The findings demonstrate the superiority of dynamic over static parameters, with the combination of VTI and PLR representing the most consistent approach. In contrast, vena cava indices show greater variability and context-dependent limitations, while emerging methods such as carotid flow assessment require further validation. In conclusion, no single method is universally applicable, and an integrated, context-based approach is essential, with POCUS playing a central role in clinical decision-making.

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References

ASOGWA, C. et al. The utility of echocardiography in estimating fluid responsiveness. Journal of Clinical Medicine Research, v. 16, n. 2, p. 85–93, 2024. DOI: 10.14740/jocmr5050

BOU CHEBL, R. et al. Bedside echocardiography and passive leg raise as a measure of volume responsiveness in the emergency department. Journal of Ultrasound in Medicine, v. 37, n. 1, p. 141–150, 2018. DOI: 10.1002/jum.14338

BOU CHEBL, R. et al. Mitral valve velocity time integral and passive leg raise as a measure of volume responsiveness. Critical Ultrasound Journal, v. 10, n. 1, p. 1–8, 2018. DOI: 10.1186/s13089-018-0097-0

BUBENEK-TURCONI, S. et al. The value of a superior vena cava collapsibility index in predicting fluid responsiveness. Journal of Clinical Monitoring and Computing, v. 33, n. 6, p. 1027–1033, 2019. DOI: 10.1007/s10877-019-00282-3

DAI, Y. et al. Predicting fluid responsiveness in spontaneously breathing patients using carotid blood flow. BMC Pregnancy and Childbirth, v. 24, n. 1, p. 1–9, 2024. DOI: 10.1186/s12884-024-06234-5

HOTZ, J.; VAN GEMMERN, J.; KRIEGE, M. Are we always right? Evaluation of the performance of passive leg raising in clinical practice. Journal of Clinical Medicine, v. 13, n. 4, p. 1–12, 2024. DOI: 10.3390/jcm13040987

ISHIZUKA, K.; SU, B. Critical care echocardiography for fluid responsiveness. Texas Heart Institute Journal, v. 50, n. 1, p. e217851, 2023. DOI: 10.14503/THIJ-21-7851

MA, X. et al. The diagnostic accuracy of inferior vena cava respiratory variation in predicting fluid responsiveness: a systematic review and meta-analysis. BMC Anesthesiology, v. 22, n. 1, p. 1–12, 2022a. DOI: 10.1186/s12871-022-01679-5

MA, X. et al. Comparison of superior and inferior vena cava diameter variation in predicting fluid responsiveness: a systematic review and meta-analysis. BMC Anesthesiology, v. 22, n. 1, p. 1–13, 2022b. DOI: 10.1186/s12871-022-01678-6

MACIULIENE, A. et al. Variability of left ventricular outflow tract velocity time integral during breathing cycle may predict fluid responsiveness. Medicina, v. 53, n. 4, p. 245–252, 2017. DOI: 10.1016/j.medici.2017.07.003

MONNET, X.; SHI, R.; TEBOUL, J. L. Prediction of fluid responsiveness: what’s new? Annals of Intensive Care, v. 12, n. 1, p. 1–10, 2022. DOI: 10.1186/s13613-022-01057-5

NOOR, A. et al. Point-of-care ultrasound use in hemodynamic assessment. Biomedicines, v. 13, n. 1, p. 1–15, 2025. DOI: 10.3390/biomedicines13010045

PÉREZ-MANJARREZ, A. et al. Usefulness of the velocity-time integral of the left ventricular outflow tract in predicting fluid responsiveness. Echo Research and Practice, v. 10, n. 1, p. 1–9, 2023. DOI: 10.1186/s44156-023-00045-2

PICCIONI, A. et al. From fluid responsiveness to prognosis: the emerging role of echocardiography in sepsis. Diagnostics, v. 15, n. 1, p. 1–14, 2025. DOI: 10.3390/diagnostics15010067

RICE, J. et al. The POCUS consult: how point-of-care ultrasound helps guide clinical decision making. International Journal of General Medicine, v. 14, p. 3171–3182, 2021. DOI: 10.2147/IJGM.S307151

ROY, C. et al. Left ventricular longitudinal strain variations and fluid responsiveness. PLOS ONE, v. 16, n. 6, p. e0252812, 2021. DOI: 10.1371/journal.pone.0252812

SURESH, V. et al. Fluid responsiveness to passive leg raising in perioperative patients. Annals of Cardiac Anaesthesia, v. 23, n. 3, p. 299–304, 2020. DOI: 10.4103/aca.ACA_72_19

ZHANG, Z. et al. Respiratory variations of inferior vena cava fail to predict fluid responsiveness in patients with left ventricular dysfunction. Annals of Intensive Care, v. 9, n. 1, p. 1–9, 2019. DOI: 10.1186/s13613-019-0527-8

Published

2026-04-17

How to Cite

FUCHS, Luan Caimar et al. USE OF POINT-OF-CARE ULTRASOUND (POCUS) IN THE ASSESSMENT OF FLUID RESPONSIVENESS: PRACTICAL APPLICATIONS AND METHODS . LUMEN ET VIRTUS, [S. l.], v. 17, n. 59, p. e12900, 2026. DOI: 10.56238/levv17n59-044. Disponível em: https://periodicos.newsciencepubl.com/LEV/article/view/12900. Acesso em: 19 apr. 2026.