VExUS for evaluation of venous congestion in a patient with mixed cardiogenic and distributive shock, acute respiratory failure, bibasilar infiltrates, and acute kidney injury.
Step 1: IVC diameter is 2.5 cm
Step 2: hepatic vein doppler assessment showing reversal of the systolic wave.
Step 3: Portal vein doppler assessment showing more than 50% variability
That will make it VExUS grade 3 as there are2 severe abnormal patterns.
Of note, we could not detect renal vein flow doppler.
Very beautiful demonstration
It helps to suggest offloading rather than fluid resuscitation
It requires stady hands and minimal pt movement (abd wise) in order to catch the image in PW mode
If my memory serves me right, there were only limited data from multiple case report
No strong data to suggest outcome
Yet a useful tool to add on for the management
If we have research, i think mortality outcome, Cr trend, O2 requirements, vasopressors doses would be excellent markers for monitoring
Thank you Dr Mazen for your amazing continuous contribution to enriching our knowledge