Value of the venous excess ultrasound grading system in individualized fluid management for sepsis
- 1Department of Critical Care Medicine,Mianyang Central Hospital,School of Medicine,University of Electronic Scienceand Technology of China,Mianyang,Sichuan 621000,China
Abstract
Early fluid resuscitation is essential for correcting tissue hypoperfusion in patients with sepsis. However,a persistently positive fluid balance after initial resuscitation may contribute to adverse outcomes,including respiratory failure and acute kidney injury(AKI). Conventional volumetric and hemodynamic parameters have limited value in accurately assessing fluid tolerance and venous-side burden during the post-resuscitation phase,as they are readily influenced by factors such as mechanical ventilation,right ventricular function,and intra-abdominal pressure. The venous excess ultrasound grading system(VExUS),which integrates Doppler assessment of the hepatic,portal,and intrarenal veins,has emerged as a promising tool for evaluating systemic venous congestion.Current evidence suggests that a VExUS grade ≥2 is associated with an increased risk of AKI. In addition,VExUS-guided fluid management may help reduce fluid accumulation and some complications,while dynamic changes of VExUS and the velocity-time integral(VTI)-VExUS index also have potential value in identifying high-risk sepsis phenotypes. This review summarizes the clinical value,recent advances,and current limitations of VExUS in post-resuscitation fluid management for sepsis.
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BibTeX
@article{liang2026value,
title = {{Value of the venous excess ultrasound grading system in individualized fluid management for sepsis}},
author = {WANG Liang and XU Zhihua},
journal = {Zhongguo linchuang yanjiu},
year = {2026},
month = oct,
doi = {10.13429/j.cnki.cjcr.2026.10.030},
url = {https://doi.org/10.13429/j.cnki.cjcr.2026.10.030},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Value of the venous excess ultrasound grading system in individualized fluid management for sepsis
AU - WANG Liang
AU - XU Zhihua
PY - 2026
DA - 2026/10/26
JO - Zhongguo linchuang yanjiu
DO - 10.13429/j.cnki.cjcr.2026.10.030
UR - https://doi.org/10.13429/j.cnki.cjcr.2026.10.030
AB - Early fluid resuscitation is essential for correcting tissue hypoperfusion in patients with sepsis. However,a persistently positive fluid balance after initial resuscitation may contribute to adverse outcomes,including respiratory failure and acute kidney injury(AKI). Conventional volumetric and hemodynamic parameters have limited value in accurately assessing fluid tolerance and venous-side burden during the post-resuscitation phase,as they are readily influenced by factors such as mechanical ventilation,right ventricular function,and intra-abdominal pressure. The venous excess ultrasound grading system(VExUS),which integrates Doppler assessment of the hepatic,portal,and intrarenal veins,has emerged as a promising tool for evaluating systemic venous congestion.Current evidence suggests that a VExUS grade ≥2 is associated with an increased risk of AKI. In addition,VExUS-guided fluid management may help reduce fluid accumulation and some complications,while dynamic changes of VExUS and the velocity-time integral(VTI)-VExUS index also have potential value in identifying high-risk sepsis phenotypes. This review summarizes the clinical value,recent advances,and current limitations of VExUS in post-resuscitation fluid management for sepsis.
SN - 1674-8182
ER -