Related Experiment Video
Updated: May 29, 2026
05:49
Demystifying Venous Excess Ultrasound (VExUS): Image Acquisition and Interpretation
Published on: May 16, 2025
Venous Excess Ultrasound Score and Acute Kidney Injury in Patients With Acute Heart Failure
Diego Araiza-Garaygordobil1, Eder Gonzalez-Macedo2, Eduardo Argaiz3
1Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, México; División de Estudios de Posgrado, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
JACC. Advances
|May 28, 2026
Summary
The Venous Excess Ultrasound Score (VExUS) is linked to acute kidney injury (AKI) in acute heart failure patients. Higher VExUS scores indicate increased venous congestion and a greater risk of developing AKI.
Area of Science:
- Cardiology
- Nephrology
- Critical Care Medicine
- Medical Imaging
Background:
- Systemic venous congestion is a known risk factor for acute kidney injury (AKI) in critically ill patients.
- The Venous Excess Ultrasound Score (VExUS) is a noninvasive ultrasound-based method to assess venous congestion.
Purpose of the Study:
- To investigate the association between the VExUS score and the incidence of AKI in patients admitted with acute heart failure (AHF).
- To determine if VExUS can serve as a predictor of AKI in the AHF population.
Main Methods:
- A prospective study enrolled 109 patients diagnosed with acute heart failure.
- VExUS scoring was performed within 8 hours of hospital admission to quantify venous congestion.
- Patients were categorized based on VExUS scores (0-1 for mild/no congestion, 2-3 for severe congestion); AKI was defined by KDIGO criteria.
Main Results:
- 37.2% of patients (41/109) had significant congestion (VExUS >1).
- A higher VExUS grade correlated with an increased proportion of patients developing AKI (VExUS=0: 29.2%, VExUS=1: 44%, VExUS=2: 66.6%, VExUS=3: 60.7%).
- Patients with VExUS >1 had a significantly increased risk of AKI (HR: 2.65) and VExUS >1 was the strongest independent predictor of AKI (OR: 4.60).
Conclusions:
- The VExUS score is significantly associated with the occurrence of AKI in patients with acute heart failure.
- VExUS may be a valuable tool for identifying AHF patients at higher risk for AKI.
- Further research is warranted to fully elucidate the clinical utility of VExUS assessment in managing heart failure.
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:22Acute Kidney Injury VI: Nursing Management
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
01:22Acute Kidney Injury I: Introduction
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
01:29Acute Kidney Injury II: Pathophysiology
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
01:29Acute Kidney Injury III: Clinical Manifestations
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...