Portal and Splenic Venous Pulsatility in Postoperative Critically Ill Patients

Venous congestion is common in critically ill postoperative patients and may be associated with adverse outcomes. Doppler ultrasound assessment of venous flow patterns, including portal venous pulsatility, is increasingly used to evaluate systemic venous congestion. This prospective observational study aims to determine the correlation between portal venous pulsatility and splenic venous pulsatility measured by Doppler ultrasound in adult patients admitted to a postoperative intensive care unit. The study will evaluate whether splenic venous pulsatility may provide additional information for the assessment of venous congestion. Ultrasound examinations will be performed in addition to standard clinical care, without any therapeutic intervention or modification of patient management.

nclusion Criteria: Adults aged ≥18 years. Admission to the postoperative intensive care unit within 72 hours after surgery. Adequate abdominal ultrasound window allowing visualization of the portal vein and splenic vein. Written informed consent provided by the patient or legally authorized representative according to local regulations. Exclusion Criteria: Known chronic liver disease or previous portal hypertension. Previous pathological splenomegaly or prior splenectomy. Recent hepatic or splenic surgery during the same hospitalization. Known portal or splenic vein thrombosis. Absence of an adequate ultrasound window after two attempts by trained operators. Death or discharge from the intensive care unit before completion of the first protocolized ultrasound assessment.