Medición de la congestión venosa empleando la ecografía: protocolo VExUS

Abstract

Acute Heart Failure (AHF) is a clinical syndrome characterized by the appearance or worsening of cardinal symptoms derived from venous congestion, which carries a high morbidity and mortality burden. Unfortunately, in current clinical practice, common markers such as patient’s history, physical examination, and complementary tests are not sensitive enough for reliable assessment of volume status. In recent years, the use of Point-of-Care Ultrasound (POCUS) has been consolidated as a useful tool to detect the presence and degree of venous congestion, providing a substantial improvement in the diagnosis and therapeutic management of these patients. In combination, pulmonary ultrasound, echocardiography and renal, suprahepatic and portal venous flow patterns (VExUS protocol), we will be able better understand the venous pathophysiology. This will allow us to identify the hemodynamic phenotype in patients with heart failure or to determine the target organ damage derived from heart failure (i.e., cardiorenal syndrome). All this would allow us to make an individualized adjustment of the treatment, as well as to serve as a prognostic marker of the evolution of the disease