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Congress: ECR25
Poster Number: C-19930
Type: Poster: EPOS Radiologist (educational)
Authorblock: P. M. A. Da Silva1, F. S. Muñoz1, A. Zakharova2, T. Rebello1, J. Traila Campos1; 1Viana do Castelo/PT, 2Kharkiv/UA
Disclosures:
Pedro Miguel Alves Da Silva: Nothing to disclose
Fabiana Santos Muñoz: Nothing to disclose
Anastasiia Zakharova: Nothing to disclose
Tulio Rebello: Nothing to disclose
José Traila Campos: Nothing to disclose
Keywords: Abdomen, Emergency, Veins / Vena cava, Ultrasound, Diagnostic procedure, Education and training, Haemodynamics / Flow dynamics
Learning objectives - To give a brief explanation on the utility of the VExUS protocol, its indications and advantages compared to other methods of estimating systemic venous pressure.- To describe the technique and scoring system and its interpretation- To display the normal and abnormal findings on wave doppler study
Read more Background Effectively managing fluids in the various clinical scenarios while preventing fluid overload can be challenging. Traditionally, hemodynamic management in the unstable and critically ill patient prioritizes maintaining adequate blood pressure and cardiac output. However, other factors like the arteriovenous gradient are often overlooked and play a crucial role in organ perfusion, which may be compromised by elevated venous pressure. Clinically significant organ congestion can develop in patients with right ventricular failure, pulmonary hypertension, or fluid overload. In critically ill patients,...
Read more Findings and procedure details The VExUS score is based on the assessment of four distinct vascular structures, providing an estimation of venous pressure in various organs, including the liver, bowel, and kidneys, as illustrated in Figure 1 [fig 1] . When additional intravascular volume due to congestion exceeds the systemic venous capacitance, a rapid rise in venous pressure occurs, leading to vessel dilation and/or abnormal Doppler waveforms. The score is determined by evaluating the inferior vena cava diameter along with the Doppler waveforms of the hepatic,...
Read more Conclusion The arteriovenous gradient is a crucial determinant of organ perfusion; however, it is often overlooked in clinical practice, with greater emphasis placed on arterial pressure and cardiac output. This consideration becomes particularly significant in the management of critically ill patients. The integration of VExUS into clinical practice enhances the precision of fluid management, allowing for tailored decongestive strategies that optimize patient outcomes. As research continues to validate its application across various settings, the VExUS score represents an evolving tool in...
Read more References Beaubien-Souligny, W., Rola, P., Haycock, K. et al. Quantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system. Ultrasound J 12, 16 (2020). https://doi.org/10.1186/s13089-020-00163-wAbhilash Koratala, Gregorio Romero-González, Hatem Soliman-Aboumarie, Amir Kazory; Unlocking the Potential of VExUS in Assessing Venous Congestion: The Art of Doing It Right. Cardiorenal Med 14 May 2024; 14 (1): 350–374. https://doi.org/10.1159/000539469Richards JR, McGahan JP. Focused Assessment with Sonography in Trauma (FAST) in 2017: What Radiologists Can Learn. Radiology. 2017;283(1):30-48. doi:10.1148/radiol.2017160107   Di Nicolò P, Tavazzi G, Nannoni L, Corradi F. Inferior Vena Cava...
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