Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion

Abstract Venous congestion, often associated with elevated right atrial pressure presents a clinical challenge due to its varied manifestations and potential organ damage. Recognizing the manifestations of venous congestion through bedside physical examination or laboratory tests can be challenging....

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Main Authors: Taweevat Assavapokee, Philippe Rola, Nicha Assavapokee, Abhilash Koratala
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:The Ultrasound Journal
Subjects:
Online Access:https://doi.org/10.1186/s13089-024-00396-z
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author Taweevat Assavapokee
Philippe Rola
Nicha Assavapokee
Abhilash Koratala
author_facet Taweevat Assavapokee
Philippe Rola
Nicha Assavapokee
Abhilash Koratala
author_sort Taweevat Assavapokee
collection DOAJ
description Abstract Venous congestion, often associated with elevated right atrial pressure presents a clinical challenge due to its varied manifestations and potential organ damage. Recognizing the manifestations of venous congestion through bedside physical examination or laboratory tests can be challenging. Point-of-care ultrasound (POCUS) is emerging as a valuable bedside tool for assessing venous congestion, with the Venous Excess Ultrasound (VExUS) technique gaining prominence. VExUS facilitates non-invasive quantification of venous congestion, relying on measurements of the inferior vena cava (IVC) size and Doppler assessments of the hepatic vein (HV), portal vein (PV), and intrarenal vein, thereby providing real-time insights into hemodynamic status and guiding therapeutic interventions. The grading system outlined in VExUS aids in stratifying the severity of congestion. However, achieving proficiency in VExUS requires a comprehensive understanding of Doppler techniques and their clinical applications. This review article provides practical guidance on performing VExUS, encompassing equipment requirements, preparation, machine settings, and examination techniques for assessing the inferior vena cava (IVC), hepatic vein (HV), portal vein (PV), and intrarenal vein. Potential pitfalls and troubleshooting strategies are discussed to ensure accurate interpretation of Doppler waveforms.
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institution Kabale University
issn 2524-8987
language English
publishDate 2024-11-01
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series The Ultrasound Journal
spelling doaj-art-19c74a40d7d144c4b7983ba8e7d9b0892025-01-19T12:14:38ZengSpringerOpenThe Ultrasound Journal2524-89872024-11-0116111610.1186/s13089-024-00396-zDecoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestionTaweevat Assavapokee0Philippe Rola1Nicha Assavapokee2Abhilash Koratala3Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Intensive Care, Santa Cabrini HospitalDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn UniversityDivision of Nephrology, Department of Medicine, Medical College of WisconsinAbstract Venous congestion, often associated with elevated right atrial pressure presents a clinical challenge due to its varied manifestations and potential organ damage. Recognizing the manifestations of venous congestion through bedside physical examination or laboratory tests can be challenging. Point-of-care ultrasound (POCUS) is emerging as a valuable bedside tool for assessing venous congestion, with the Venous Excess Ultrasound (VExUS) technique gaining prominence. VExUS facilitates non-invasive quantification of venous congestion, relying on measurements of the inferior vena cava (IVC) size and Doppler assessments of the hepatic vein (HV), portal vein (PV), and intrarenal vein, thereby providing real-time insights into hemodynamic status and guiding therapeutic interventions. The grading system outlined in VExUS aids in stratifying the severity of congestion. However, achieving proficiency in VExUS requires a comprehensive understanding of Doppler techniques and their clinical applications. This review article provides practical guidance on performing VExUS, encompassing equipment requirements, preparation, machine settings, and examination techniques for assessing the inferior vena cava (IVC), hepatic vein (HV), portal vein (PV), and intrarenal vein. Potential pitfalls and troubleshooting strategies are discussed to ensure accurate interpretation of Doppler waveforms.https://doi.org/10.1186/s13089-024-00396-zVenous excess ultrasoundVExUSVenous congestionPoint-of-care ultrasound
spellingShingle Taweevat Assavapokee
Philippe Rola
Nicha Assavapokee
Abhilash Koratala
Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion
The Ultrasound Journal
Venous excess ultrasound
VExUS
Venous congestion
Point-of-care ultrasound
title Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion
title_full Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion
title_fullStr Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion
title_full_unstemmed Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion
title_short Decoding VExUS: a practical guide for excelling in point-of-care ultrasound assessment of venous congestion
title_sort decoding vexus a practical guide for excelling in point of care ultrasound assessment of venous congestion
topic Venous excess ultrasound
VExUS
Venous congestion
Point-of-care ultrasound
url https://doi.org/10.1186/s13089-024-00396-z
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