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Explore VExUS Made Easy: 4 Simple Steps to Assess Venous Congestion with 15,677 views, 345 likes, and 2 comments. Experience the impact of this video content that has captured audience attention.

VExUS Simplified: A Step-by-Step Guide to Assessing Venous Congestion 1. Start with the IVC (Inferior Vena Cava): Use a subxiphoid view in short axis via liver window Measure IVC 1–2 cm below the RA–IVC or HV–IVC junction Long-axis shows IVC connecting to RA and hepatic vein IVC 2 cm or less = VExUS Grade 0 (Asian patients may need a lower cutoff) Use B-mode or M-mode to check collapsibility 2. Assess the Hepatic Vein (HV): Use subxiphoid or coronal view Place Doppler gate 1–2 cm into the HV, away from junction Ask patient to hold breath at end-expiration Doppler waveforms: A-wave (retrograde) = atrial contraction (P wave) S-wave (antegrade) = systole (QRS) V-wave (retrograde) = end-systole D-wave (antegrade) = diastole (after T wave) Normally S is greater than D. In congestion, S weakens or reverses 3. Evaluate Portal Vein (PV): Use coronal view near the right kidney Color Doppler shows continuous red flow toward the probe Pulsatility Index (PVPF = max minus min, divided by max): Under 30 percent = Normal 30 to 50 percent = Mild congestion Over 50 percent = Severe Flow reversal = Very severe congestion 4. Check Intrarenal Veins (IRV): Scan in coronal view over the kidney Use color Doppler: red = arterial, blue = venous Place PW Doppler on interlobar or arcuate veins Normal = smooth, continuous flow with little pulsatility Congestion = interrupted, pulsatile flow with distinct S and D waves Use arterial waveform to match with cardiac phases #VExUS #POCUS #Ultrasound #Shock #CriticalCare #emergencymedicine #resusultrasound

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