ReviewCritical care (London, England)2025
VExUS score: optimizing its use in perioperative and critical care management.
Review in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07691944 (Effect of VExUS Score-Guided Intraoperative Goal-Directed Fluid Therapy on Postoperative Pulmonary Complications in Elderly Patients Undergoing McKeown Minimally Invasive Esophagectomy), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Effect of VExUS Score-Guided Intraoperative Goal-Directed Fluid Therapy on Postoperative Pulmonary Complications in Elderly Patients Undergoing McKeown Minimally Invasive Esophagectomy: A Randomized Controlled Trial
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline 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
- Clinical value of the venous volume excess ultrasound score (VExUS) for volume management following cardiopulmonary bypass (CPB).Journal of ultrasound · 2026Trial
- Comparison of oral water ingestion and intravenous fluid infusion on fluid responsiveness in healthy volunteers, a prospective, randomized trial.Scientific reports · 2026Trial
- Integrated haemodynamic monitoring of fluid responsiveness and fluid tolerance in critical care: from physiology to bedside applications.Journal of clinical monitoring and computing · 2026Review
- Right ventricular-pulmonary arterial uncoupling and venous excess in normotensive pulmonary embolism shock.Critical care (London, England) · 2026Article
- A Guyton-based hypothesis for venous congestion.The ultrasound journal · 2026Article
- Correction: VExUS score: optimizing its use in perioperative and critical care management.Critical care (London, England) · 2026Article
- Physiology, monitoring, and optimisation of perioperative tissue oxygenation: a narrative review.British journal of anaesthesia · 2026Review
- Central Venous Pressure Revisited: Physiology, Pitfalls, Misconceptions, and Modern Clinical Interpretation in Critical Care.Journal of clinical medicine · 2026Review
- VExUS versus CVP for assessing venous congestion: oasis or mirage?Critical care (London, England) · 2026Article
- Relationship between high VExUS score and echocardiographic parameters: a systematic review and meta-analysis.Journal of anesthesia, analgesia and critical care · 2026Review
- Femoral vein Doppler ultrasound for assessing venous congestion and right heart function: a scoping review.Intensive care medicine experimental · 2026Review
- Venous congestion in critical care: combining VExUS, lung ultrasound, and echocardiography.Annals of intensive care · 2026Article
- Association between venous excess ultrasound score and major adverse kidney events at 30 days in critically ill elderly patients: a multicenter prospective cohort study.Frontiers in medicine · 2026Article
- Renal congestion syndrome in critically ill patients: a neglected mechanism of acute kidney injury - A narrative review.Annals of intensive care · 2026Review
- Venous excess and lung ultrasound during continuous renal replacement therapy in critically ill patients (VExLUS-RRT): a prospective observational study.Annals of intensive care · 2026Article
- Early assessment of fluid tolerance (VExUS) and stroke volume (LVOT-VTI) to predict adverse outcomes in emergency department patients with suspected sepsis.Annals of intensive care · 2026Article
- Assessing venous congestion in critical illness: advantages of the inferior vena cava shape change index over diameter.Annals of intensive care · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Venous Excess Ultrasound (VExUS) score has been developed to grade venous congestion and predict acute kidney injury in cardiac surgical setting by combining inferior vena cava diameter with hepatic, portal, and renal venous Doppler patterns. While initial studies demonstrated associations with acute kidney injury, subsequent non cardiac setting ICU studies yielded contradictory results, prompting reevaluation of what VExUS actually measures. Analysis of VExUS components reveals the score reflects complex interactions between cardiac function, filling pressures, and volume status rather than pure volume assessment. Each component-IVC diameter, hepatic vein flow, portal vein flow, and renal vein flow-is differently influenced by cardiac function and volume status. Observational studies demonstrate that patients with highest VExUS scores often have cardiogenic shock despite low fluid balance, while those with significant volume excess may have low scores when cardiac function is preserved. This evolving understanding necessitates a correction in clinical practice, returning to the original physiological framework where VExUS reflects the interaction of venous return and cardiac function rather than simple volume overload parameter.
Indexed as
Identifiers
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.