Today, I reviewed and link to VExUS in Nephrology: Case Examples from NephroPOCUS. Nov, 2023.
All that follows is from the above resource.
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!
The article gives us nine brief cases. Carefully review each case and then review the article associated with that specific case. The articles associated with the cases are outstanding.
The article associated with Case 1 is Multi-Organ Point-Of-Care Ultrasound in Acute Kidney Injury, Blood Purif (2022) 51 (12): 967–971.
https://doi.org/10.1159/000522652. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF].
The article associated with Cases 2 + 3 is Venous Excess Doppler Ultrasound for the Nephrologist: Pearls and Pitfalls. Kidney Med. 2022 May 19;4(7):100482. doi: 10.1016/j.xkme.2022.100482. eCollection 2022 Jul. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF].
The article associated with Case 4 is Nephrologist-Performed Point-of-Care Ultrasound in Acute Kidney Injury: Beyond Hydronephrosis. Kidney Int Rep. 2022 Mar 4;7(6):1428-1432. doi: 10.1016/j.ekir.2022.02.017. eCollection 2022 Jun. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF].
The article associated with Case 5 is Nephrologist-performed point-of-care venous excess Doppler ultrasound (VExUS) in the management of acute kidney injury. J Ultrasound. 2023 Mar;26(1):301-306. doi: 10.1007/s40477-022-00760-6. Epub 2023 Jan 8. [PubMed Abscess] Free full-text article not available.
The article associated with Case 6 is Evaluation of Venous Congestion Using Beside Ultrasonography by the Nephrology Consultant: The VExUS Nexus. POCUS J. 2022 Feb 1;7(Kidney):17-20. doi: 10.24908/pocus.v7iKidney.15341. eCollection 2022. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF].
The article associated with Case 7 is Point-of-care venous Doppler ultrasound in the management of heart failure and hyponatremia. Clinical Nephrology, Volume 96 (2021) – July (63 – 66), doi: 10.5414/CN110388. [Link to download the PDF].
The article associated with Case 8 is Utility of portal venous Doppler in the assessment of fluid status in end-stage kidney disease: think beyond IVC ultrasound. CEN Case Rep. 2022 May; 11(2): 285–287. Published online 2021 Nov 9. doi: 10.1007/s13730-021-00661-3. [Full-Text HTML] [Full-TextPDF].
The article associated with Case 9 is Venous Excess Doppler Ultrasound: A Visual Guide to Decongestion in Cardiorenal Syndrome. Case Rep Nephrol Dial. 2023 Oct 6;13(1):156-161. doi: 10.1159/000531709. eCollection 2023 Jan-Dec. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF].
