Behind the Scenes Videos

What is the VExUS Score? 

Key Points:

• • VExUS is a composite venous doppler score derived in a cardiac surgery cohort, used to grade systemic congestion.
  • Higher scores (0–3) correlate with AKI, delirium, and encephalopathy
  • Assesses IVC, hepatic, portal, and intrarenal venous Doppler.
  • Needs further validation in broader populations.
  • Common pitfalls:
    • Overreliance on IVC size (small IVC doesn’t exclude congestion).
    • Overinterpreting complex hepatic waveforms.
    • Intrarenal stasis index may reflect baseline congestion in some patients.
  • Most valuable as a serial assessment when patients aren’t improving. – Strong basic CV POCUS skills are essential before using VExUS

What is “Fluid Tolerance”

Key Points:

• IVF have both benefits and risks, the balance varies by patient.
• Key considerations: acute illness, chronic comorbidities, and current congestion.
• Risks: congestive organ injury, pulmonary edema
• Potential benefits: increased mean systemic filling pressure improved cardiac output.
• Use IVF judiciously to avoid congestive injury. Early vasopressors can be considered

Full Podcast Episode

Venous Congestion & VEXUS: Interview with Dr. Ross Prager