VExUS in ICU | Venous Excess Ultrasound – A Practical Approach to Venous Congestion

VExUS (Venous Excess Ultrasound) is a practical bedside ultrasound approach to assessing systemic venous congestion in critically ill patients. In this video, we discuss how to perform and interpret the VExUS assessment in ICU, including: • IVC assessment and its limitations • Hepatic vein Doppler patterns • Portal vein Doppler and pulsatility • Intrarenal venous Doppler patterns • How to determine the VExUS grade • How VExUS can help identify clinically significant venous congestion • Integration of VExUS with cardiac function, fluid status and haemodynamics • Important pitfalls and limitations in critically ill patients The focus is on a pragmatic bedside approach that can be incorporated into critical care echocardiography and haemodynamic assessment. 00:00 Introduction 00:14 Core concept. 01:11 HD assessment 02:27 Why VExUS was developed? 03:52 IVC 04:54 Why to use VExUS ? 06:04 Original VExUS study. 06:35 What does VExUS measure ? 06:52 hepatic vein 07:08 Portal vein 07:26 Indications of VExUS 09:38 Probe 10:30 Organ perfusion pressure. 11:46 IVC the gate keeper 12:43 IVC short axis 13:31 Hepatic vein 14:30 hepatic vein waveforms 20:15 Portal venous waveform 22:55 Intrarenal doppler assesment 26:11 VExUS grading