How to Simplify the Venous Ultrasound Excess Score
Monday, April 8, 2024
11:02am – 11:09am
Location: 412
Authors: Stephanie midgley, Nuvance Health Nahal Nikroo, Banner University Medical Center Joseph Felice, Vassar Brothers Medical Center
Venous congestion is deleterious in critically ill patients, correlating with end-organ dysfunction, ICU length of stay, and mortality. Severity of congestion can be graded with the Venous Excess Ultrasound (VExUS) score, utilizing IVC distention and spectral Doppler (sD) waveforms of hepatic, portal, and renal venous systems on ultrasound. VExUS scores are challenging to acquire and interpret, especially hepatic veins (HV) waveforms. Our objective is to evaluate the accuracy of a simplified VExUS protocol utilizing color Doppler in lieu of spectral Doppler of the HV.
The accuracy of the simplified VExUS protocol was 94% (95% CI0.83-0.99) with an F1 score of 0.94, p< 0.05. The sensitivity and specificity for each score are Grade 0 is 100% and 100%, Grade 1 is 88% and 94%, Grade 2 is 91% and 64%, and Grade 3 is 73% and 100%.
The simplified VExUS score protocol may be a reasonable approach for the EP to rule out venous congestion (grade 0 or 1) or rule in severe venous congestion (grade 3).