Ultrasound of systemic venous congestion (VExUS) by using transesophageal echocardiography (T-VExUS) in critically ill patients: general aspects and technical description.
DOI:
https://doi.org/10.37615/retic.v9n1a3Keywords:
ultrasonography, point-of-care ultrasound, venous system, congestion, heart failureAbstract
Introduction. Systemic venous congestion is a factor of morbidity and mortality in heart failure and other critical conditions. It can be identified through transthoracic and abdominal ultrasonography using the VExUS Score to predict the development of acute kidney injury after cardiac surgery, as well as in other Intensive Care Unit (ICU). There is limited information in the literature regarding this examination via the transesophageal approach (T-VExUS) as a complement to point-of-care ultrasound in critically ill patients. Objective. Synthesize the acutal evidence on the VExUS examination generalities, describe the transesophageal approach technique as well as possible advantages and limitations regarding the abdominal approach. Methods. A narrative review of PubMed and Google Scholar (September 2015 to September 2025), supplemented by past relevant studies. The images were obtained as part of the hemodynamic evaluation using TEE performed in the ICU, utilizing standardized esophageal and transgastric windows with some additional probe manipulations.
Key Content and Findings. T-VExUS can provide decisive data on hemodynamic status within the ICU. It is an effective alternative that resolves the visibility issues of the conventional method in critically ill patients, especially when combined with a TEE. Conclusion. T-VExUS is a fundamental hemodynamic tool that allows the evaluation of venous congestion in critical patients when the physical limitations of the clinical environment make the standard abdominal approach impossible.
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