Fluid Assessment by Venous Excess Ultrasound
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Abstract
Critically ill patients often experience fluid overload, which is associated with an increased risk of complications and mortality. One key pathophysiological aspect of fluid overload is fluid accumulation in the venous system and/or impaired cardiac function, affecting both systolic and diastolic phases (systolic and diastolic dysfunction). This results in reduced perfusion to vital organs, making the rapid and timely diagnosis and treatment of fluid overload crucial for\ minimizing complications and reducing patient mortality. Traditional physical examination methods may be prone to errors. Currently, a panel of ultrasound techniques known as ‘Point of Care Ultrasound’ (POCUS) refers to the use of ultrasound for specific purposes to guide treatment decisions. POCUS can be performed on multiple organs, a practice referred to as multi-organ POCUS, which includes the assessment of the heart, lungs, and veins. Venous Excess Ultrasound (VExUS), a component of POCUS, is a novel Doppler technique used to assess fluid overload in the venous system. However, VExUS should not be used to predict responsiveness to fluid management. This examination primarily focuses on the inferior vena cava, followed by the hepatic, portal, and renal veins.
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