VExUS is an emerging field, and consequently, its practical application in day-to-day clinical practice is not widely acknowledged. Presented below are selected cases we have published (as of November 2023), each conveying a unique teaching point. Links to the full articles are provided; click on the word ‘case’.
VExUS is not limited to a specific specialty or clinical setting but falls within the purview of POCUS-competent physicians taking care of patients with changing hemodynamic profiles. Remember to use simultaneous EKG where possible (for precise interpretation of hepatic vein and cardiac Doppler) and interpret VExUS findings in conjunction with cardiopulmonary POCUS and the relevant clinical context. Below is the VExUS grading card if you need a refresher. Happy scanning!
Here is a summary slide on the interpretation of VeXuS from the above resource.
Dr. Abhilash Koratala from the Medical College of Wisconsin introduces VEXUS, or Venous Excess Ultrasound, for assessing hemodynamics and fluid status at the bedside in critical care and emergency medicine. He breaks down the components of VEXUS, including hepatic vein, portal vein, and intrarenal vein waveforms, and explains how they indicate venous congestion. Dr. Koratala emphasizes the importance of VEXUS in evaluating organ perfusion and its ability to provide additional information beyond traditional methods like Central Venous Pressure reading. He concludes by sharing a real-life case study where VEXUS helped guide diuretic therapy and monitor its effectiveness in treating venous congestion. This lecture provides valuable insights for healthcare professionals in managing patients with fluid overload and organ injury.