{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:12:12Z","timestamp":1789071132409,"version":"build-2803163510"},"reference-count":76,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Monit Comput"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The framework of fluid responsiveness addresses only whether volume expansion will augment cardiac output, not whether the circulation can accept that volume without producing congestive organ injury. The complementary concept of fluid tolerance has accumulated empirical support over recent years and is integral to understanding patients\u2019 fluid status. This narrative review synthesises the physiological basis of fluid responsiveness and fluid tolerance, describes the bedside monitoring tools available to assess each, and considers the clinical implications of their joint interpretation in critical care. We performed a literature search restricted to articles published between 2020 and the date of the search. The retrieved abstracts were evaluated for relevance, and their reference lists were subsequently screened to identify additional pertinent publications. Fluid responsiveness and fluid tolerance are dissociable but physiologically interdependent, sharing determinants such as biventricular function, stressed volume and venous capacitance. Dynamic tests remain the preferred approach for assessing preload responsiveness; each has specific applicability conditions, and many require continuous or rapidly repeated cardiac output monitoring. Emerging tools have been developed to assess fluid tolerance, primarily based on vascular sonography; their interpretation requires concurrent assessment of biventricular function and further validation. Reframing fluid stewardship around the interaction between responsiveness and tolerance shifts the focus from forward-flow alone to net physiological benefit. No single parameter or device fully captures fluid status. An integrated, serial, multi-parametric assessment supported by appropriate monitoring platforms is therefore preferable to reliance on any single measure. At present, these tools support fluid stewardship rather than representing interventions with independently proven survival benefit. Future priorities include defining organ-specific congestion thresholds and testing whether monitoring-informed protocols improve outcomes.<\/jats:p>","DOI":"10.1007\/s10877-026-01467-3","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:52:26Z","timestamp":1783659146000},"page":"1077-1089","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated haemodynamic monitoring of fluid responsiveness and fluid tolerance in critical care: from physiology to bedside applications"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8372-9176","authenticated-orcid":false,"given":"Henrique","family":"Mendes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Zentar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"1467_CR1","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1056\/NEJMra1208943","volume":"369","author":"JL Vincent","year":"2013","unstructured":"Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013;369:1726\u201334. https:\/\/doi.org\/10.1056\/NEJMra1208943.","journal-title":"N Engl J Med"},{"key":"1467_CR2","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1001\/jama.2016.12310","volume":"316","author":"P Bentzer","year":"2016","unstructured":"Bentzer P, Griesdale DE, Boyd J, MacLean K, Sirounis D, Ayas NT. Will this hemodynamically unstable patient respond to a bolus of intravenous fluids? JAMA. 2016;316:1298\u2013309. https:\/\/doi.org\/10.1001\/jama.2016.12310.","journal-title":"JAMA"},{"key":"1467_CR3","doi-asserted-by":"publisher","first-page":"154367","DOI":"10.1016\/j.jcrc.2023.154367","volume":"78","author":"T Tackaert","year":"2023","unstructured":"Tackaert T, Van Moorter N, De Mey N, Demeyer I, De Decker K. The association between increasing fluid balance, acute kidney injury and mortality in patients with sepsis and septic shock: a retrospective single center audit. J Crit Care. 2023;78:154367. https:\/\/doi.org\/10.1016\/j.jcrc.2023.154367.","journal-title":"J Crit Care"},{"key":"1467_CR4","doi-asserted-by":"publisher","first-page":"17410","DOI":"10.1038\/s41598-023-44778-0","volume":"13","author":"Y Hayashi","year":"2023","unstructured":"Hayashi Y, Shimazui T, Tomita K, et al. Associations between fluid overload and outcomes in critically ill patients with acute kidney injury: a retrospective observational study. Sci Rep. 2023;13:17410. https:\/\/doi.org\/10.1038\/s41598-023-44778-0.","journal-title":"Sci Rep"},{"key":"1467_CR5","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.1097\/CCM.0000000000004617","volume":"48","author":"AS Messmer","year":"2020","unstructured":"Messmer AS, Zingg C, M\u00fcller M, Gerber JL, Schefold JC, Pfortmueller CA. Fluid overload and mortality in adult critical care patients: a systematic review and meta-analysis of observational studies. Crit Care Med. 2020;48:1862\u201370. https:\/\/doi.org\/10.1097\/CCM.0000000000004617.","journal-title":"Crit Care Med"},{"key":"1467_CR6","doi-asserted-by":"publisher","first-page":"154070","DOI":"10.1016\/j.jcrc.2022.154070","volume":"71","author":"E Kattan","year":"2022","unstructured":"Kattan E, Castro R, Miralles-Aguiar F, Hern\u00e1ndez G, Rola P. The emerging concept of fluid tolerance: a position paper. J Crit Care. 2022;71:154070. https:\/\/doi.org\/10.1016\/j.jcrc.2022.154070.","journal-title":"J Crit Care"},{"key":"1467_CR7","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13054-024-04834-1","volume":"28","author":"F Mu\u00f1oz","year":"2024","unstructured":"Mu\u00f1oz F, Born P, Bruna M, et al. Coexistence of a fluid responsive state and venous congestion signals in critically ill patients: a multicenter observational proof-of-concept study. Crit Care. 2024;28:52. https:\/\/doi.org\/10.1186\/s13054-024-04834-1.","journal-title":"Crit Care"},{"key":"1467_CR8","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s13054-024-04930-2","volume":"28","author":"A Joseph","year":"2024","unstructured":"Joseph A, Petit M, Vignon P, Vieillard-Baron A. Fluid responsiveness and venous congestion: unraveling the nuances of fluid status. Crit Care. 2024;28:140. https:\/\/doi.org\/10.1186\/s13054-024-04930-2.","journal-title":"Crit Care"},{"key":"1467_CR9","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s13613-023-01177-y","volume":"13","author":"MLNG Malbrain","year":"2023","unstructured":"Malbrain MLNG, Caironi P, Hahn RG, et al. Multidisciplinary expert panel report on fluid stewardship: perspectives and practice. Ann Intensive Care. 2023;13:89. https:\/\/doi.org\/10.1186\/s13613-023-01177-y.","journal-title":"Ann Intensive Care"},{"key":"1467_CR10","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1111\/anae.16633","volume":"80","author":"P Lloyd-Donald","year":"2025","unstructured":"Lloyd-Donald P, Fujino M, Waldman B, Miles LF. Measurement and interpretation of central venous pressure: a narrative review. Anaesthesia. 2025;80:1093\u2013102. https:\/\/doi.org\/10.1111\/anae.16633.","journal-title":"Anaesthesia"},{"key":"1467_CR11","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s10877-024-01255-x","volume":"39","author":"A Messina","year":"2025","unstructured":"Messina A, Grieco DL, Alicino V, et al. Assessing fluid responsiveness by using functional hemodynamic tests in critically ill patients: a narrative review and a profile-based clinical guide. J Clin Monit Comput. 2025;39:481\u201393. https:\/\/doi.org\/10.1007\/s10877-024-01255-x.","journal-title":"J Clin Monit Comput"},{"key":"1467_CR12","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s10877-025-01397-6","volume":"40","author":"M Mirus","year":"2026","unstructured":"Mirus M, Saugel B, Spieth PM. Hemodynamic monitoring: basic principles in operation room and intensive care unit. J Clin Monit Comput. 2026;40:375\u201389. https:\/\/doi.org\/10.1007\/s10877-025-01397-6.","journal-title":"J Clin Monit Comput"},{"key":"1467_CR13","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s12551-015-0184-4","volume":"7","author":"V van der Sequeira","year":"2015","unstructured":"van der Sequeira V. Historical perspective on heart function: the Frank\u2013Starling Law. Biophys Rev. 2015;7:421\u201347. https:\/\/doi.org\/10.1007\/s12551-015-0184-4.","journal-title":"Biophys Rev"},{"key":"1467_CR14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s13054-015-0776-1","volume":"19","author":"DA Berlin","year":"2015","unstructured":"Berlin DA, Bakker J. Starling curves and central venous pressure. Crit Care. 2015;19:55. https:\/\/doi.org\/10.1186\/s13054-015-0776-1.","journal-title":"Crit Care"},{"key":"1467_CR15","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s13054-022-04024-x","volume":"26","author":"R Persichini","year":"2022","unstructured":"Persichini R, Lai C, Teboul JL, Adda I, Gu\u00e9rin L, Monnet X. Venous return and mean systemic filling pressure: physiology and clinical applications. Crit Care. 2022;26:150. https:\/\/doi.org\/10.1186\/s13054-022-04024-x.","journal-title":"Crit Care"},{"key":"1467_CR16","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1097\/01.CCM.0000227646.98423.98","volume":"34","author":"S Magder","year":"2006","unstructured":"Magder S. Central venous pressure: a useful but not so simple measurement. Crit Care Med. 2006;34:2224\u20137. https:\/\/doi.org\/10.1097\/01.CCM.0000227646.98423.98.","journal-title":"Crit Care Med"},{"key":"1467_CR17","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-026-08366-w","author":"S Bhattacharjee","year":"2026","unstructured":"Bhattacharjee S, Ferrer R, Hamzaoui O. Cardiac output and determinants. Intensive Care Med. 2026. https:\/\/doi.org\/10.1007\/s00134-026-08366-w.","journal-title":"Intensive Care Med"},{"key":"1467_CR18","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1097\/01.CCM.0000249851.94101.4F","volume":"35","author":"D Osman","year":"2007","unstructured":"Osman D, Ridel C, Ray P, et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med. 2007;35:64\u20138. https:\/\/doi.org\/10.1097\/01.CCM.0000249851.94101.4F.","journal-title":"Crit Care Med"},{"key":"1467_CR19","doi-asserted-by":"publisher","first-page":"2000","DOI":"10.1378\/chest.121.6.2000","volume":"121","author":"F Michard","year":"2002","unstructured":"Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest. 2002;121:2000\u20138. https:\/\/doi.org\/10.1378\/chest.121.6.2000.","journal-title":"Chest"},{"key":"1467_CR20","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s13613-022-01022-8","volume":"12","author":"X Monnet","year":"2022","unstructured":"Monnet X, Shi R, Teboul JL. Prediction of fluid responsiveness: what\u2019s new? Ann Intensive Care. 2022;12:46. https:\/\/doi.org\/10.1186\/s13613-022-01022-8.","journal-title":"Ann Intensive Care"},{"key":"1467_CR21","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1164\/ajrccm.162.1.9903035","volume":"162","author":"F Michard","year":"2000","unstructured":"Michard F, Boussat S, Chemla D, et al. Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med. 2000;162:134\u20138. https:\/\/doi.org\/10.1164\/ajrccm.162.1.9903035.","journal-title":"Am J Respir Crit Care Med"},{"key":"1467_CR22","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1164\/rccm.201801-0088CI","volume":"199","author":"JL Teboul","year":"2019","unstructured":"Teboul JL, Monnet X, Chemla D, Michard F. Arterial pulse pressure variation with mechanical ventilation. Am J Respir Crit Care Med. 2019;199:22\u201331. https:\/\/doi.org\/10.1164\/rccm.201801-0088CI.","journal-title":"Am J Respir Crit Care Med"},{"key":"1467_CR23","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1186\/s13054-023-04629-w","volume":"27","author":"JI Alvarado S\u00e1nchez","year":"2023","unstructured":"Alvarado S\u00e1nchez JI, Caicedo Ruiz JD, Diaztagle Fern\u00e1ndez JJ, et al. Variables influencing the prediction of fluid responsiveness: a systematic review and meta-analysis. Crit Care. 2023;27:361. https:\/\/doi.org\/10.1186\/s13054-023-04629-w.","journal-title":"Crit Care"},{"key":"1467_CR24","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/bja\/aer187","volume":"107","author":"B Lansdorp","year":"2011","unstructured":"Lansdorp B, Ouweneel D, de Keijzer A, Lemson J, Pickkers P. Non-invasive measurement of pulse pressure variation and systolic pressure variation using a finger cuff corresponds with intra-arterial measurement. Br J Anaesth. 2011;107:540\u20135. https:\/\/doi.org\/10.1093\/bja\/aer187.","journal-title":"Br J Anaesth"},{"key":"1467_CR25","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.bja.2020.03.013","volume":"125","author":"B Saugel","year":"2020","unstructured":"Saugel B, Hoppe P, Nicklas JY, et al. Continuous noninvasive pulse wave analysis using finger cuff technologies for arterial blood pressure and cardiac output monitoring in perioperative and intensive care medicine: a systematic review and meta-analysis. Br J Anaesth. 2020;125:25\u201337. https:\/\/doi.org\/10.1016\/j.bja.2020.03.013.","journal-title":"Br J Anaesth"},{"key":"1467_CR26","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1097\/EJA.0000000000000998","volume":"36","author":"A Messina","year":"2019","unstructured":"Messina A, Montagnini C, Cammarota G, et al. Tidal volume challenge to predict fluid responsiveness in the operating room: an observational study. Eur J Anaesthesiol. 2019;36:583\u201391. https:\/\/doi.org\/10.1097\/EJA.0000000000000998.","journal-title":"Eur J Anaesthesiol"},{"key":"1467_CR27","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s13613-016-0216-7","volume":"6","author":"X Monnet","year":"2016","unstructured":"Monnet X, Marik P, Teboul JL. Prediction of fluid responsiveness: an update. Ann Intensive Care. 2016;6:111. https:\/\/doi.org\/10.1186\/s13613-016-0216-7.","journal-title":"Ann Intensive Care"},{"key":"1467_CR28","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s00134-008-1293-3","volume":"35","author":"J Jabot","year":"2009","unstructured":"Jabot J, Teboul JL, Richard C, Monnet X. Passive leg raising for predicting fluid responsiveness: importance of the postural change. Intensive Care Med. 2009;35:85\u201390. https:\/\/doi.org\/10.1007\/s00134-008-1293-3.","journal-title":"Intensive Care Med"},{"key":"1467_CR29","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s13054-014-0708-5","volume":"19","author":"X Monnet","year":"2015","unstructured":"Monnet X, Teboul JL. Passive leg raising: five rules, not a drop of fluid! Crit Care. 2015;19:18. https:\/\/doi.org\/10.1186\/s13054-014-0708-5.","journal-title":"Crit Care"},{"key":"1467_CR30","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.1007\/s00134-015-4134-1","volume":"42","author":"X Monnet","year":"2016","unstructured":"Monnet X, Marik P, Teboul JL. Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis. Intensive Care Med. 2016;42:1935\u201347. https:\/\/doi.org\/10.1007\/s00134-015-4134-1.","journal-title":"Intensive Care Med"},{"key":"1467_CR31","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1097\/01.CCM.0000215453.11735.06","volume":"34","author":"X Monnet","year":"2006","unstructured":"Monnet X, Rienzo M, Osman D, et al. Passive leg raising predicts fluid responsiveness in the critically ill. Crit Care Med. 2006;34:1402\u20137. https:\/\/doi.org\/10.1097\/01.CCM.0000215453.11735.06.","journal-title":"Crit Care Med"},{"key":"1467_CR32","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s10877-021-00662-8","volume":"36","author":"IT Bootsma","year":"2022","unstructured":"Bootsma IT, Boerma EC, de Lange F, Scheeren TWL. The contemporary pulmonary artery catheter. Part 1: placement and waveform analysis. J Clin Monit Comput. 2022;36:5\u201315. https:\/\/doi.org\/10.1007\/s10877-021-00662-8.","journal-title":"J Clin Monit Comput"},{"key":"1467_CR33","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s13054-017-1739-5","volume":"21","author":"X Monnet","year":"2017","unstructured":"Monnet X, Teboul JL. Transpulmonary thermodilution: advantages and limits. Crit Care. 2017;21:147. https:\/\/doi.org\/10.1186\/s13054-017-1739-5.","journal-title":"Crit Care"},{"key":"1467_CR34","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.ccrj.2024.04.003","volume":"26","author":"L Bitker","year":"2024","unstructured":"Bitker L, Noirot I, Chauvelot L, et al. Bias, trending ability and diagnostic performance of a non-calibrated multi-beat analysis continuous cardiac output monitor to identify fluid responsiveness in critically ill patients. Crit Care Resusc. 2024;26:108\u201315. https:\/\/doi.org\/10.1016\/j.ccrj.2024.04.003.","journal-title":"Crit Care Resusc"},{"key":"1467_CR35","doi-asserted-by":"publisher","first-page":"100036","DOI":"10.1016\/j.aicoj.2026.100036","volume":"16","author":"R Castro","year":"2026","unstructured":"Castro R, Kattan E, Melo P, Amthauer M, Hern\u00e1ndez G. The time course of fluid responsiveness. Ann Intensive Care. 2026;16:100036. https:\/\/doi.org\/10.1016\/j.aicoj.2026.100036.","journal-title":"Ann Intensive Care"},{"key":"1467_CR36","doi-asserted-by":"publisher","first-page":"101370","DOI":"10.1016\/j.accpm.2024.101370","volume":"43","author":"PG Guinot","year":"2024","unstructured":"Guinot PG, Longrois D, Andrei S, Nguyen M, Bouhemad B. Exploring congestion endotypes and their distinct clinical outcomes among ICU patients: a post-hoc analysis. Anaesth Crit Care Pain Med. 2024;43:101370. https:\/\/doi.org\/10.1016\/j.accpm.2024.101370.","journal-title":"Anaesth Crit Care Pain Med"},{"key":"1467_CR37","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1186\/s13054-025-05687-y","volume":"29","author":"PG Guinot","year":"2025","unstructured":"Guinot PG. VExUS score: optimizing its use in perioperative and critical care management. Crit Care. 2025;29:472. https:\/\/doi.org\/10.1186\/s13054-025-05687-y.","journal-title":"Crit Care"},{"key":"1467_CR38","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1186\/s13054-020-03345-z","volume":"24","author":"A Vieillard-Baron","year":"2020","unstructured":"Vieillard-Baron A, Prigent A, Repess\u00e9 X, et al. Right ventricular failure in septic shock: characterization, incidence and impact on fluid responsiveness. Crit Care. 2020;24:630. https:\/\/doi.org\/10.1186\/s13054-020-03345-z.","journal-title":"Crit Care"},{"key":"1467_CR39","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.jcmg.2018.10.038","volume":"13","author":"SF Nagueh","year":"2020","unstructured":"Nagueh SF. Left ventricular diastolic function: understanding pathophysiology, diagnosis, and prognosis with echocardiography. JACC Cardiovasc Imaging. 2020;13:228\u201344. https:\/\/doi.org\/10.1016\/j.jcmg.2018.10.038.","journal-title":"JACC Cardiovasc Imaging"},{"key":"1467_CR40","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/j.jacc.2008.05.068","volume":"53","author":"W Mullens","year":"2009","unstructured":"Mullens W, Abrahams Z, Francis GS, et al. Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol. 2009;53:589\u201396. https:\/\/doi.org\/10.1016\/j.jacc.2008.05.068.","journal-title":"J Am Coll Cardiol"},{"key":"1467_CR41","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1097\/MCC.0000000000000991","volume":"28","author":"JJ De Waele","year":"2022","unstructured":"De Waele JJ. Intra-abdominal hypertension and abdominal compartment syndrome. Curr Opin Crit Care. 2022;28:695\u2013701. https:\/\/doi.org\/10.1097\/MCC.0000000000000991.","journal-title":"Curr Opin Crit Care"},{"key":"1467_CR42","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s13054-018-2292-6","volume":"23","author":"R Uchimido","year":"2019","unstructured":"Uchimido R, Schmidt EP, Shapiro NI. The glycocalyx: a novel diagnostic and therapeutic target in sepsis. Crit Care. 2019;23:16. https:\/\/doi.org\/10.1186\/s13054-018-2292-6.","journal-title":"Crit Care"},{"key":"1467_CR43","doi-asserted-by":"publisher","first-page":"361","DOI":"10.5603\/AIT.2014.0060","volume":"46","author":"MLNG Malbrain","year":"2014","unstructured":"Malbrain MLNG, Marik PE, Witters I, et al. Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: a systematic review with suggestions for clinical practice. Anaesthesiol Intensive Ther. 2014;46:361\u201380. https:\/\/doi.org\/10.5603\/AIT.2014.0060.","journal-title":"Anaesthesiol Intensive Ther"},{"key":"1467_CR44","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1007\/s00134-023-07101-z","volume":"49","author":"A Pesenti","year":"2023","unstructured":"Pesenti A, Slobod D, Magder S. The forgotten relevance of central venous pressure monitoring. Intensive Care Med. 2023;49:868\u201370. https:\/\/doi.org\/10.1007\/s00134-023-07101-z.","journal-title":"Intensive Care Med"},{"key":"1467_CR45","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s13089-020-00163-w","volume":"12","author":"W Beaubien-Souligny","year":"2020","unstructured":"Beaubien-Souligny W, Rola P, Haycock K, Bouchard J, Lamarche Y, Spiegel R. Quantifying systemic congestion with point-of-care ultrasound: development of the venous excess ultrasound grading system. Ultrasound J. 2020;12:16. https:\/\/doi.org\/10.1186\/s13089-020-00163-w.","journal-title":"Ultrasound J"},{"key":"1467_CR46","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1093\/ehjacc\/zuae126","volume":"14","author":"S Andrei","year":"2025","unstructured":"Andrei S, Nguyen M, Bouhemad B, Guinot PG. High VExUS grades are linked to cardiac function in general intensive care unit patients. Eur Heart J Acute Cardiovasc Care. 2025;14:24\u201330. https:\/\/doi.org\/10.1093\/ehjacc\/zuae126.","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"1467_CR47","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s13613-025-01498-0","volume":"15","author":"C Balan","year":"2025","unstructured":"Balan C, Morosanu B, Fodoroiu A, et al. Decoding portal vein pulsatility: hemodynamic determinants in a post-hoc analysis of a prospective observational trial. Ann Intensive Care. 2025;15:81. https:\/\/doi.org\/10.1186\/s13613-025-01498-0.","journal-title":"Ann Intensive Care"},{"key":"1467_CR48","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1186\/s13613-025-01609-x","volume":"15","author":"ZI Bitar","year":"2025","unstructured":"Bitar ZI, Maadarani OS, Bitar M. Ultrasound indicators of organ venous congestion: a narrative review. Ann Intensive Care. 2025;15:184. https:\/\/doi.org\/10.1186\/s13613-025-01609-x.","journal-title":"Ann Intensive Care"},{"key":"1467_CR49","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000535641","volume":"14","author":"JP Islas-Rodr\u00edguez","year":"2024","unstructured":"Islas-Rodr\u00edguez JP, Miranda-Aquino T, Romero-Gonz\u00e1lez G, et al. Effect on kidney function recovery guiding decongestion with VExUS in patients with cardiorenal syndrome 1: a randomized control trial. Cardiorenal Med. 2024;14:1\u201311. https:\/\/doi.org\/10.1159\/000535641.","journal-title":"Cardiorenal Med"},{"key":"1467_CR50","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1186\/s13054-024-05124-6","volume":"28","author":"B Morosanu","year":"2024","unstructured":"Morosanu B, Balan C, Boros C, et al. Incidence, predictability, and outcomes of systemic venous congestion following a fluid challenge in initially fluid-tolerant preload-responders after cardiac surgery: a pilot trial. Crit Care. 2024;28:339. https:\/\/doi.org\/10.1186\/s13054-024-05124-6.","journal-title":"Crit Care"},{"key":"1467_CR51","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13054-025-05803-y","volume":"30","author":"X Si","year":"2026","unstructured":"Si X, Cao D, Shi R, et al. Fluid responsiveness and changes in venous congestion and lung water during volume expansion in critically ill patients. Crit Care. 2026;30:35. https:\/\/doi.org\/10.1186\/s13054-025-05803-y.","journal-title":"Crit Care"},{"key":"1467_CR52","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s40635-026-00856-x","volume":"14","author":"RH Melo","year":"2026","unstructured":"Melo RH, Wong A, Koratala A, Kattan E, Passos RH. Femoral vein Doppler ultrasound for assessing venous congestion and right heart function: a scoping review. Intensive Care Med Exp. 2026;14:4. https:\/\/doi.org\/10.1186\/s40635-026-00856-x.","journal-title":"Intensive Care Med Exp"},{"key":"1467_CR53","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1378\/chest.09-0001","volume":"136","author":"DA Lichtenstein","year":"2009","unstructured":"Lichtenstein DA, M\u00e9zi\u00e8re GA, Lagoueyte JF, Biderman P, Goldstein I, Gepner A. A-lines and B-lines: lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill. Chest. 2009;136:1014\u201320. https:\/\/doi.org\/10.1378\/chest.09-0001.","journal-title":"Chest"},{"key":"1467_CR54","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1186\/s13054-022-04061-6","volume":"26","author":"F Gavelli","year":"2022","unstructured":"Gavelli F, Shi R, Teboul JL, et al. Extravascular lung water levels are associated with mortality: a systematic review and meta-analysis. Crit Care. 2022;26:202. https:\/\/doi.org\/10.1186\/s13054-022-04061-6.","journal-title":"Crit Care"},{"key":"1467_CR55","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1097\/CCM.0b013e31826ab377","volume":"41","author":"M Jozwiak","year":"2013","unstructured":"Jozwiak M, Silva S, Persichini R, et al. Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit Care Med. 2013;41:472\u201380. https:\/\/doi.org\/10.1097\/CCM.0b013e31826ab377.","journal-title":"Crit Care Med"},{"key":"1467_CR56","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.jcrc.2016.02.011","volume":"33","author":"H Wang","year":"2016","unstructured":"Wang H, Cui N, Su L, et al. Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation. J Crit Care. 2016;33:106\u201313. https:\/\/doi.org\/10.1016\/j.jcrc.2016.02.011.","journal-title":"J Crit Care"},{"key":"1467_CR57","doi-asserted-by":"publisher","first-page":"2080","DOI":"10.1378\/chest.122.6.2080","volume":"122","author":"SG Sakka","year":"2002","unstructured":"Sakka SG, Klein M, Reinhart K, Meier-Hellmann A. Prognostic value of extravascular lung water in critically ill patients. Chest. 2002;122:2080\u20136. https:\/\/doi.org\/10.1378\/chest.122.6.2080.","journal-title":"Chest"},{"key":"1467_CR58","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/CCM.0b013e3181feeb15","volume":"39","author":"JH Boyd","year":"2011","unstructured":"Boyd JH, Forbes J, Nakada T, Walley KR, Russell JA. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011;39:259\u201365. https:\/\/doi.org\/10.1097\/CCM.0b013e3181feeb15.","journal-title":"Crit Care Med"},{"key":"1467_CR59","doi-asserted-by":"publisher","first-page":"226","DOI":"10.5935\/2965-2774.20230012-en","volume":"35","author":"RH Melo","year":"2023","unstructured":"Melo RH, Santos MH, Ramos FJ. Beyond fluid responsiveness: the concept of fluid tolerance and its potential implication in hemodynamic management. Crit Care Sci. 2023;35:226\u20139. https:\/\/doi.org\/10.5935\/2965-2774.20230012-en.","journal-title":"Crit Care Sci"},{"key":"1467_CR60","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1016\/j.ultrasmedbio.2025.11.003","volume":"52","author":"P Klompmaker","year":"2026","unstructured":"Klompmaker P, Mousa A, Allard DJ, et al. Ultrasound assessment of fluid tolerance in critically ill patients: epidemiology of systemic and pulmonary congestion. Ultrasound Med Biol. 2026;52:596\u2013601. https:\/\/doi.org\/10.1016\/j.ultrasmedbio.2025.11.003.","journal-title":"Ultrasound Med Biol"},{"key":"1467_CR61","doi-asserted-by":"publisher","first-page":"155485","DOI":"10.1016\/j.jcrc.2026.155485","volume":"93","author":"R Castro","year":"2026","unstructured":"Castro R, Retamal J, Hern\u00e1ndez G, Kattan E, Pinsky MR. Critical closing pressure in the circulation: understanding the vascular waterfall phenomenon. J Crit Care. 2026;93:155485. https:\/\/doi.org\/10.1016\/j.jcrc.2026.155485.","journal-title":"J Crit Care"},{"key":"1467_CR62","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1186\/s40635-025-00828-7","volume":"13","author":"R Castro","year":"2025","unstructured":"Castro R, Kattan E, Retamal J, Hern\u00e1ndez G, Pinsky MR. Venous congestion from a vascular waterfall perspective: reframing congestion as a dynamic Starling resistor phenomenon. Intensive Care Med Exp. 2025;13:119. https:\/\/doi.org\/10.1186\/s40635-025-00828-7.","journal-title":"Intensive Care Med Exp"},{"key":"1467_CR63","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1001\/jama.2023.7560","volume":"329","author":"FG Zampieri","year":"2023","unstructured":"Zampieri FG, Bagshaw SM, Semler MW. Fluid therapy for critically ill adults with sepsis: a review. JAMA. 2023;329:1967\u201380. https:\/\/doi.org\/10.1001\/jama.2023.7560.","journal-title":"JAMA"},{"key":"1467_CR64","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1164\/rccm.201812-2342OC","volume":"200","author":"L Gattinoni","year":"2019","unstructured":"Gattinoni L, Vasques F, Camporota L, et al. Understanding lactatemia in human sepsis: potential impact for early management. Am J Respir Crit Care Med. 2019;200:582\u20139. https:\/\/doi.org\/10.1164\/rccm.201812-2342OC.","journal-title":"Am J Respir Crit Care Med"},{"key":"1467_CR65","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s13613-018-0400-z","volume":"8","author":"X Monnet","year":"2018","unstructured":"Monnet X, Teboul JL. My patient has received fluid. How to assess its efficacy and side effects? Ann Intensive Care. 2018;8:54. https:\/\/doi.org\/10.1186\/s13613-018-0400-z.","journal-title":"Ann Intensive Care"},{"key":"1467_CR66","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s40635-023-00582-8","volume":"11","author":"B Saravi","year":"2023","unstructured":"Saravi B, Goebel U, Hassenzahl LO, et al. Capillary leak and endothelial permeability in critically ill patients: a current overview. Intensive Care Med Exp. 2023;11:96. https:\/\/doi.org\/10.1186\/s40635-023-00582-8.","journal-title":"Intensive Care Med Exp"},{"key":"1467_CR67","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1016\/j.chest.2020.04.025","volume":"158","author":"IS Douglas","year":"2020","unstructured":"Douglas IS, Alapat PM, Corl KA, et al. Fluid response evaluation in sepsis hypotension and shock (FRESH): a randomized clinical trial. Chest. 2020;158:1431\u201345. https:\/\/doi.org\/10.1016\/j.chest.2020.04.025.","journal-title":"Chest"},{"key":"1467_CR68","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1097\/CCM.0000000000007075","volume":"54","author":"HC Prescott","year":"2026","unstructured":"Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54:725\u2013812. https:\/\/doi.org\/10.1097\/CCM.0000000000007075.","journal-title":"Crit Care Med"},{"key":"1467_CR69","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s10877-008-9147-7","volume":"22","author":"WG Parkin","year":"2008","unstructured":"Parkin WG, Leaning MS. Therapeutic control of the circulation. J Clin Monit Comput. 2008;22:391\u2013400. https:\/\/doi.org\/10.1007\/s10877-008-9147-7.","journal-title":"J Clin Monit Comput"},{"key":"1467_CR70","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s13613-018-0418-2","volume":"8","author":"M Wijnberge","year":"2018","unstructured":"Wijnberge M, Sindhunata DP, Pinsky MR, et al. Estimating mean circulatory filling pressure in clinical practice: a systematic review comparing three bedside methods in the critically ill. Ann Intensive Care. 2018;8:73. https:\/\/doi.org\/10.1186\/s13613-018-0418-2.","journal-title":"Ann Intensive Care"},{"key":"1467_CR71","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000007219","author":"P Klompmaker","year":"2026","unstructured":"Klompmaker P, Opschoor K, ten Dalen J, et al. Diagnostic and prognostic value of the venous excess ultrasound grading system: a systematic review and meta-analysis. Crit Care Med. 2026. https:\/\/doi.org\/10.1097\/CCM.0000000000007219.","journal-title":"Crit Care Med"},{"key":"1467_CR72","doi-asserted-by":"publisher","first-page":"155488","DOI":"10.1016\/j.jcrc.2026.155488","volume":"94","author":"S Ter Horst","year":"2026","unstructured":"Ter Horst S, van Oosten J, Laros R, et al. VExUS-ED: early venous congestion is associated with clinical fluid overload in patients with sepsis. J Crit Care. 2026;94:155488. https:\/\/doi.org\/10.1016\/j.jcrc.2026.155488.","journal-title":"J Crit Care"},{"key":"1467_CR73","doi-asserted-by":"publisher","first-page":"e074843","DOI":"10.1136\/bmjopen-2023-074843","volume":"13","author":"R Prager","year":"2023","unstructured":"Prager R, Argaiz E, Pratte M, et al. Doppler identified venous congestion in septic shock: protocol for an international, multi-centre prospective cohort study (Andromeda-VEXUS). BMJ Open. 2023;13:e074843. https:\/\/doi.org\/10.1136\/bmjopen-2023-074843.","journal-title":"BMJ Open"},{"key":"1467_CR74","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1164\/rccm.201401-0056CP","volume":"189","author":"MO Harhay","year":"2014","unstructured":"Harhay MO, Wagner J, Ratcliffe SJ, et al. Outcomes and statistical power in adult critical care randomized trials. Am J Respir Crit Care Med. 2014;189:1469\u201378. https:\/\/doi.org\/10.1164\/rccm.201401-0056CP.","journal-title":"Am J Respir Crit Care Med"},{"key":"1467_CR75","doi-asserted-by":"publisher","first-page":"e759","DOI":"10.1097\/CCM.0000000000005637","volume":"50","author":"A Granholm","year":"2022","unstructured":"Granholm A, Anthon CT, Kj\u00e6r MBN, et al. Patient-important outcomes other than mortality in contemporary ICU trials: a scoping review. Crit Care Med. 2022;50:e759\u201371. https:\/\/doi.org\/10.1097\/CCM.0000000000005637.","journal-title":"Crit Care Med"},{"key":"1467_CR76","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1186\/s13063-023-07171-w","volume":"24","author":"SG Blok","year":"2023","unstructured":"Blok SG, Mousa A, Brouwer MG, et al. Effect of lung ultrasound-guided fluid deresuscitation on duration of ventilation in intensive care unit patients (CONFIDENCE): protocol for a multicentre randomised controlled trial. Trials. 2023;24:226. https:\/\/doi.org\/10.1186\/s13063-023-07171-w.","journal-title":"Trials"}],"container-title":["Journal of Clinical Monitoring and Computing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-026-01467-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10877-026-01467-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-026-01467-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:02:42Z","timestamp":1789070562000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10877-026-01467-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":76,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["1467"],"URL":"https:\/\/doi.org\/10.1007\/s10877-026-01467-3","relation":{},"ISSN":["1573-2614"],"issn-type":[{"value":"1573-2614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"7 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable; no human or animal participants were involved in this narrative review.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}