VExUS Point-of-Care Ultrasound Tool to Detect Changes in Volume Status: A Prospective Observational Study

Area of Science:

• Nephrology
• Radiology
• Critical Care Medicine

Background:

• Venous excess ultrasound score (VExUS) is an emerging point-of-care ultrasound tool for evaluating venous congestion.
• VExUS utilizes inferior vena cava (IVC) diameter and hepatic vein pulse-wave Doppler.
• The ability of VExUS to detect dynamic changes in intravascular volume is not well established.

Purpose of the Study:

• To investigate the capability of a standardized point-of-care ultrasound examination to capture dynamic changes in patient volume status.
• To assess the utility of VExUS in monitoring fluid shifts.

Main Methods:

• Prospective observational study involving inpatients with end-stage renal disease.
• VExUS examinations were performed before and after hemodialysis (HD).
• A composite VExUS score was calculated, and univariate linear regression analyzed the relationship between fluid removed and VExUS score change.

Main Results:

• Forty-six patients completed the study, with 92 paired ultrasound exams.
• A median decrease of 1.5 in VExUS score was observed post-hemodialysis (P < 0.001).
• No significant linear relationship was found between the volume of fluid removed and the change in VExUS score.

Conclusions:

• Fluid removal during hemodialysis is associated with significant changes in the VExUS score.
• VExUS demonstrates utility in capturing dynamic shifts in intravascular volume in end-stage renal disease patients.
• This study supports the use of VExUS as a point-of-care tool for volume status assessment.