ArticleThe ultrasound journal2020
Quantifying systemic congestion with Point-Of-Care ultrasound: development of the venous excess ultrasound grading system.
Article in The ultrasound journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 11 registered trials, which are not on this map. Cited by 346 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimizing Fluid Management Informed by Ultrasound for Patients With Sepsis
Dynamic Changes in Portal Vein Flow in Decongestion of Patients With Heart Failure and Cardio-Renal Syndrome
External Validation of the VExUS Score for the Prediction of Acute Renal Failure in Cardiac Surgery
Intrarenal Venous Flow Change During Fluid Removal in Critically Ill Patients: A Prospective Exploratory Study
Description and Analysis of Congestion During Hospitalization for Acute Decompensated Heart Failure
Venous Excess Ultrasound Score (VExUS) Combined With Central Venous Pressure (CVP) to Predict Clinical Outcomes in Sepsis Participants
A Parallel-group, Single-center, Two-arm Treatment Study to Assess the Safety and Effectiveness of Venous Ultrasound Guided Decongestion in Adult Patients Hospitalized with Acute Decompensated Heart Failure.
Effect of VExUS Ultrasound Protocol (Venous Excess Ultrasound) on Perioperative Fluid Management, on the Incidence of Postoperative Pulmonary Complications and Postoperative Acute Kidney Injury in Patients Undergoing Thoracic Surgery
Incorporating the Venous Excess Ultrasound Score (VExUS Score) Into Contemporary Haemodynamic Risk Assessment in Pulmonary Arterial Hypertension: The INVEXUS-PAH Study
Quantification of Systemic Congestion by Ultrasound As a Predictor of Weaning Failure From Mechanical Ventilation
VEXUS-REA : Evaluation of Ultrasound Parameters of Venous Congestion in Patients in a Medical Intensive Care Unit
Who cites it
346 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Heterotopic Caval Valve Implantation for Severe Tricuspid Regurgitation: A Systematic Review and Recommendations for Implantation and Futility.Reviews in cardiovascular medicine · 2026Pooled it
- Hemodynamic monitoring strategies in cardiac surgery: an update systematic review.Journal of clinical monitoring and computing · 2026Pooled it
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Dynamic Measures of Fluid Responsiveness to Guide Resuscitation in Patients With Sepsis and Septic Shock: A Systematic Review and Meta-Analysis.Critical care explorations · 2025Pooled it
- Clinical value of the venous volume excess ultrasound score (VExUS) for volume management following cardiopulmonary bypass (CPB).Journal of ultrasound · 2026Trial
- Deresuscitation Informed by Ultrasound in Patients With Septic Shock Trial: A Pilot Randomized Controlled Study.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Trial
- A Pilot Randomized Controlled Trial of Ultrasound Evaluation of Fluid Tolerance for Acute Kidney Injury: USE-the-FORCE-for-AKI Trial.Clinical journal of the American Society of Nephrology : CJASN · 2026Trial
- Impact of renal vein doppler ultrasound-guided CVP titration in sepsis: a pilot randomized controlled trial.Critical care (London, England) · 2026Trial
- The role of intra-abdominal pressure and point of care ultrasound to guide decongestive therapies in acute heart failure.ESC heart failure · 2025Trial
- Prevention of hypotension after induction of general anesthesia using point-of-care ultrasound to guide fluid management: a randomized controlled trial.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Trial
- Pediatric Venous Excess Ultrasound Score (P-VExUS): a novel approach to assess central venous pressure in the PICU.European journal of pediatrics · 2026Observational
- What is the significance of intra-operative oliguria with regard to post-operative acute kidney injury? A physiology-informed framework for intra-operative oliguria management.Journal of anesthesia, analgesia and critical care · 2026Review
- Residual congestion and urinary sodium and chloride trajectories in acute heart failure.Internal and emergency medicine · 2026Article
- Integrated haemodynamic monitoring of fluid responsiveness and fluid tolerance in critical care: from physiology to bedside applications.Journal of clinical monitoring and computing · 2026Review
- Abdominal CT findings on the day of death in patients with solid organ malignancies.Abdominal radiology (New York) · 2026Article
- Baseline-Referenced Longitudinal Point-of-Care Ultrasound for Fluid Management After Kidney Transplantation: A Retrospective Comparison with Central Venous Pressure-Guided Care.Life (Basel, Switzerland) · 2026Article
- Personalized Sequential Nephron Blockade for Diuretic Resistance in Acute Decompensated Heart Failure: A Narrative Review for the Cardiorenal Clinician.Journal of personalized medicine · 2026Review
- Characterizing the molecular landscape of venous congestion.World journal of critical care medicine · 2026Article
- Venous dimension of shock: Integrating arterial inflow and venous back-pressure in hemodynamic assessment.World journal of critical care medicine · 2026Review
- Physiologically-Guided Ultrafiltration: A Proposed Ultrasound Framework for Individualized Volume Removal During Hemodialysis.Nephrology (Carlton, Vic.) · 2026Review
286 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOrgan congestion is a mediator of adverse outcomes in critically ill patients. Point-Of-Care ultrasound (POCUS) is widely available and could enable clinicians to detect signs of venous congestion at the bedside. The aim of this study was to develop several grading system prototypes using POCUS and to determine their respective ability to predict acute kidney injury (AKI) after cardiac surgery. This is a post-hoc analysis of a single-center prospective study in 145 patients undergoing cardiac surgery for which repeated daily measurements of hepatic, portal, intra-renal vein Doppler and inferior vena cava (IVC) ultrasound were performed during the first 72 h after surgery. Five prototypes of venous excess ultrasound (VExUS) grading system combining multiple ultrasound markers were developed.
resultsThe association between each score and AKI was assessed using time-dependant Cox models as well as conventional performance measures of diagnostic testing. A total of 706 ultrasound assessments were analyzed. We found that defining severe venous congestion as the presence of severe flow abnormalities in multiple Doppler patterns with a dilated IVC (≥ 2 cm) showed the strongest association with the development of subsequent AKI compared with other combinations (HR: 3.69 CI 1.65-8.24 p = 0.001). The association remained significant after adjustment for baseline risk of AKI and vasopressor/inotropic support (HR: 2.82 CI 1.21-6.55 p = 0.02). Furthermore, this severe VExUS grade offered a useful positive likelihood ratio (+LR: 6.37 CI 2.19-18.50) when detected at ICU admission, which outperformed central venous pressure measurements.
conclusionsThe combination of multiple POCUS markers may identify clinically significant venous congestion.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.