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Prospective observational data have suggested that the trajectory of venous congestion may carry more information than a single VExUS measurement. In a general ICU cohort, investigators measured VExUS on admission and again during the first three days, then examined the relationship between change in score and major adverse kidney events. The study found that the early change in VExUS score was associated with MAKE-30, whereas an isolated score on day 1 or day 3 was not. This supports the idea that congestion is dynamic and that the direction of change may be clinically meaningful. For HCPs, this has a practical implication: bedside ultrasound can be most useful when incorporated into serial assessment rather than used as a one-time label. A patient's venous congestion can rise or fall as fluids, vasopressors, ventilation and renal function change. This fits the conference's emphasis on dynamic haemodynamic monitoring, personalised resuscitation and ultrasound-guided volume strategy. The evidence remains observational, so VExUS should not yet be treated as a validated trigger for a specific therapy. However, serial imaging may help clinicians recognise when the haemodynamic phase of care has shifted—from resuscitation toward de-resuscitation or organ-protection.
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Prospective observational data have suggested that the trajectory of venous congestion may carry more information than a single VExUS measurement. In a general ICU cohort, investigators measured VExUS on admission and again during the first three days, then examined the relationship between change in score and major adverse kidney events. The study found that the early change in VExUS score was associated with MAKE-30, whereas an isolated score on day 1 or day 3 was not. This supports the idea that congestion is dynamic and that the direction of change may be clinically meaningful. For HCPs, this has a practical implication: bedside ultrasound can be most useful when incorporated into serial assessment rather than used as a one-time label. A patient's venous congestion can rise or fall as fluids, vasopressors, ventilation and renal function change. This fits the conference's emphasis on dynamic haemodynamic monitoring, personalised resuscitation and ultrasound-guided volume strategy. The evidence remains observational, so VExUS should not yet be treated as a validated trigger for a specific therapy. However, serial imaging may help clinicians recognise when the haemodynamic phase of care has shifted—from resuscitation toward de-resuscitation or organ-protection.
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