Vnitr Lek 2025, 71(5):306-311

Venous excess ultrasound - what we (don't) know so far

Adam Koudelka^{1, 2}, Michaela Habánová^{1, 2}, Ondřej Ludka^{1, 2}

¹ Všeobecná interní klinika, Fakultní nemocnice Brno

² Lékařská fakulta, Masarykova univerzita, Brno

Venous excess ultrasound (VExUS) is a novel, non-invasive method for the semiquantitative assessment of venous congestion, using doppler examination of the hepatic, portal and renal veins. It expands the capabilities of bedside ultrasound in evaluating a patient's hemodynamic status. Disorders of fluid balance are a common clinical issue in internal medicine, particularly in patients with cardiac or renal disease, including acute conditions. In such cases, VExUS provides a non-invasive assessment of the venous part of the circulation and enables treatment adjustments based on the findings. This review article outlines the fundamentals of VExUS, its clinical applications, and the future potential of this diagnostic tool.

Keywords: congestion, cardiorenal syndrome, inferior vena cava, pulsed wave doppler, point-of-care ultrasound, venous excess ultrasound.

Accepted: August 25, 2025; Published: September 18, 2025  Show citation