ArticleChest2024
Prospective Evaluation of Venous Excess Ultrasound for Estimation of Venous Congestion.
Article in Chest, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 45 papers.
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.
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.
The Impact of VeXUS-guided Fluid Management in ICU Populations on Renal Function
Who cites it
45 citing papers in PubMed, 47 citations in OpenAlex.
- 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
- Abbreviated Point-of-Care-Ultrasound Volume Assessment for Outpatient Hemodialysis Patients.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Two-dimensional shear wave elastography-based assessment of liver stiffness in critically ill patients with septic shock: a prospective observational study.Internal and emergency medicine · 2026Article
- Beyond Fluid Responsiveness: Why Venous Congestion Matters in Sepsis.Current medical science · 2026Article
- Venous dimension of shock: Integrating arterial inflow and venous back-pressure in hemodynamic assessment.World journal of critical care medicine · 2026Review
- Cardiogenic Shock Centers and Protocols for Acute Cardiovascular Care: Bridging the Gap Between Spoke and Hub Sites.Cardiology and therapy · 2026Review
- The Role of PoCUS in the Diagnosis and Early Monitoring of Cardiogenic Shock in the Emergency Department: A Narrative Review.Reviews in cardiovascular medicine · 2026Review
- Venous excess doppler ultrasound: What radiologists should know in 2026.World journal of radiology · 2026Review
- Rethinking Congestion in Heart Failure from Volume Overload to Venous Pressure and Organ Disfunction with VExUS.Medicina (Kaunas, Lithuania) · 2026Review
- Positioning Statement on the Use of Point-of-Care Ultrasound in Cardiovascular Medicine - 2026.Arquivos brasileiros de cardiologia · 2026Article
- Central Venous Pressure Revisited: Physiology, Pitfalls, Misconceptions, and Modern Clinical Interpretation in Critical Care.Journal of clinical medicine · 2026Review
- Feasibility and early experience with venous Doppler congestion assessment in post-operative lung transplant patients.The ultrasound journal · 2026Article
- Ten tips to control blood pressure in haemodialysis patients.Clinical kidney journal · 2026Review
- Fluid management methods for severely burned patients: a narrative review.Journal of clinical monitoring and computing · 2026Review
- Modified Venous Excess Ultrasound (mVExUS) in the Prediction of Ventilator Weaning Failure: a Cohort Study.POCUS journal · 2026Article
- Clinical and Subclinical Congestion in Acute Heart Failure: A Multimodal Prognostic Assessment.Journal of clinical medicine · 2026Article
- A comprehensive review of venous excess ultrasound (VExUS) score: evidence from original research.Internal and emergency medicine · 2026Review
- Lung and Venous Excess Ultrasound Correlation With Intracardiac Pressures Before and After Decongestion in Critically Ill Patients With Acute Decompensated Heart Failure.Critical care explorations · 2026Observational
- Association of active fluid de-escalation timing with clinical outcomes in patients with septic shock: a multicenter cohort study.BMC infectious diseases · 2026Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundVenous excess ultrasound (VExUS) is a novel ultrasound technique previously reported as a noninvasive measure of venous congestion and predictor of cardiorenal acute kidney injury. RESEARCH QUESTION: Are there associations between VExUS grade and cardiac pressures measured by right heart catheterization (RHC) and cardiac biomarkers and clinical outcomes in patients undergoing RHC? STUDY DESIGN AND
methodsWe conducted a prospective cohort study at the Denver Health Medical Center from December 20, 2022, to March 25, 2023. All patients undergoing RHC underwent a blinded VExUS assessment prior to their procedure. Multivariable regressions were conducted to assess relationships between VExUS grade and cardiac pressures, biomarkers, and changes in weight among patients with heart failure, a proxy for diuretic success. Receiver operating characteristic curve and area under the curve (AUC) were derived for VExUS, inferior vena cava (IVC) diameter, and IVC collapsibility index (ICI) to predict right atrial pressure (RAP) > 10 and < 7 mm Hg.
resultsAmong 81 patients, 45 of whom were inpatients, after adjusting for age, sex, and Charlson Comorbidity Index, there were significant relationships between VexUS grade of 2 (β = 4.8; 95% CI, 2.6-7.1; P < .01) and 3 (β = 11; 95% CI, 8.9-14; P < .01) and RAP, VExUS grade of 2 (β = 6.8; 95% CI, 0.16-13; P = .045) and 3 (β = 15; 95% CI, 7.3-22; P < .01) and mean pulmonary artery pressure, and VExUS grade of 2 (β = 7.0; 95% CI, 3.9-10; P < .01) and 3 (β = 13; 95% CI, 9.5-17; P < .01) and pulmonary capillary wedge pressure. AUC values for VExUS, IVC diameter, and ICI as predictors of RAP > 10 mm Hg were 0.9 (95% CI, 0.83-0.97), 0.77 (95% CI, 0.68-0.88), and 0.65 (95% CI, 0.52-0.78), respectively. AUC values for VExUS, IVC diameter, and ICI as predictors of RAP < 7 mm Hg were 0.79 (95% CI, 0.70-0.87), 0.74 (95% CI, 0.64-0.84), and 0.62 (95% CI, 0.49-0.76), respectively. In a subset of 23 patients with heart failure undergoing diuresis, there was a significant association between VExUS grade 3 and change in weight between time of RHC and discharge (P = .025).
interpretationAlthough more research is required, VExUS has the potential to increase diagnostic and therapeutic capabilities of physicians at the bedside and increase our understanding of the underappreciated problem of venous congestion.
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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.