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What is VExUS?

VExUS is venous excess ultrasound grading system intended to quantify systemic venous congestion, which is particularly important in patients with tenuous fluid volume status (e.g. those with right sided heart failure). It involves using Doppler ultrasound of the hepatic, portal and intra-renal veins as an adjunct to inferior vena cava assessment and better demonstrates how the organs are ‘feeling’ the congestion; in other words, congestive organ injury. Other advantage is that these Doppler waveforms can be used to monitor the efficacy of decongestive therapy. Following lectures give an overview of this topic. First one is a 15-minute snapshot of individual waveforms and the second one is a little longer with basic principles and case example.

In addition, I recommend going through the Renal Fellow Network post by Dr. Argaiz as well as this review article of ours.

Click here for some cool VExUS flash cards.



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