{"doi":"10.24908/pocus.v8i2.16792","title":"Venous Excess Ultrasound (VExUS) Grading to Assess Perioperative Fluid Status for Noncardiac Surgeries: a Prospective Observational Pilot Study","abstract":"Objectives: Perioperative fluid administration impacts the rate of complications following surgery. VExUS grading system is a standardized point of care ultrasound (POCUS)-based, comprehensive method to assess volume status. VExUS could serve as a tool to guide fluid management, if validated perioperatively. The primary aim was to assess the success rate of obtaining required windows for VExUS grading , as well as the feasibility within a perioperative setting among noncardiac surgery. Further, this study describes the incidence of perioperative venous congestion and associations with 30-day postoperative complications. Methods: This observational study was conducted in non-critically ill adults undergoing noncardiac surgery. Patients were scanned preoperatively, in the post anesthesia care unit (PACU), and 24 hours postoperatively for venous congestion. Researchers retrospectively captured 30-day complications for multivariate analyses. Results: The cohort included 69 participants. Ninety-one percent of scans over all timepoints were successfully completed. Pre-operatively, 57 (83%) scans were Grade 0, and 11 (16%) were Grade 1. Venous congestion was observed in 29 (44%) patients in the PACU (n=66). 22 (33%) patients were Grade 1, while 7 (11%) were Grade 2. At 24 hours (n=63), 31 patients (49%) had venous congestion: 20 (32%) Grade 1 and 11 (17%) Grade 2. Of the pre-operative Grade 0, 28 (50%) had at least one postoperative scan with venous congestion. No patients were Grade 3 at any timepoint. The 30-day complication rate was 32% (n=22). Eleven (16%) patients developed acute kidney injury (AKI). There was no statistically significant association between VExUS grading and all-cause complications or AKI. Conclusion: This study demonstrates that perioperative VExUS scoring is a feasible tool among a variety of noncardiac surgeries. We highlight that venous congestion is common and increases postoperatively within non-ICU populations. Larger studies are needed to assess the relationship between VExUS grading and postoperative complications.","journal":"POCUS Journal","year":2023,"id":330654,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.962,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1054895,"name":"Jacob R Wrobel","orcid":"0009-0007-6572-2636","position":1,"is_corresponding":false},{"id":649708,"name":"Xinming An","orcid":"0000-0002-8332-0362","position":2,"is_corresponding":false},{"id":1055536,"name":"J. D. Acton","orcid":null,"position":3,"is_corresponding":false},{"id":1054896,"name":"Alexander S. Doyal","orcid":"0000-0003-1238-4251","position":4,"is_corresponding":false},{"id":1054897,"name":"Shawn Jia","orcid":"0000-0003-0364-949X","position":5,"is_corresponding":false},{"id":1054898,"name":"James C. Krakowski","orcid":"0000-0003-2820-3419","position":6,"is_corresponding":false},{"id":1055537,"name":"Jay Schoenherr","orcid":null,"position":7,"is_corresponding":false},{"id":229029,"name":"Ricardo Serrano","orcid":"0000-0002-4206-3638","position":8,"is_corresponding":false},{"id":1054899,"name":"David Flynn","orcid":"0000-0003-2150-3849","position":9,"is_corresponding":false},{"id":1055538,"name":"Duncan McLean","orcid":null,"position":10,"is_corresponding":false},{"id":1054900,"name":"Stuart A. Grant","orcid":"0000-0001-9214-5175","position":11,"is_corresponding":false},{"id":1041452,"name":"Justin Magin","orcid":"0000-0002-8663-5044","position":0,"is_corresponding":true}],"reference_count":17,"raw_metadata":null,"created_at":"2026-07-19T01:09:14.691473Z","pmid":"38099161","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}