#evexus - Twitter Hashtag

NephroPOCUS

@NephroP

5 days ago

#eVExUS 🔗https://t.co/94D3SmSFb4

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NephroPOCUS

@NephroP

5 days ago

#eVExUS image of the day: Internal jugular vein Doppler, S>D #POCUS #Nephpearls

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CardioMotorizado

@EmergPOCUS

about 2 months ago

🫀📡 El día de hoy vamos a resumir el eVExUS. 🔻 Ya conocemos el VExUS como herramienta para valorar congestión venosa sistémica a pie de cama, pero ahora vale la pena repasar su extensión: #eVExUS. Hablemos un poco más de él, de por qué surgió y qué puede aportar.... 🧵

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NephroPOCUS

@NephroP

about 2 months ago

@ahmad_70x Useful when it’s unreliable or inaccessible #eVExUS https://t.co/SXPloNJpl0

NephroPOCUS

@NephroP

2 months ago

SVC is a component of #eVExUS 🔗https://t.co/94D3SmSFb4

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NephroPOCUS

@NephroP

2 months ago

SVC is a component of #eVExUS 🔗https://t.co/94D3SmSFb4

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NephroPOCUS

@NephroP

2 months ago

How to do SVC #POCUS 📹 + an illustration of abnormal SVC Doppler patterns. #VExUS #eVExUS #Nephpearls From 🔗J Am Soc Echocardiogr. 2023;36(5):447-463. doi: 10.1016/j.echo.2023.01.017

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NephroPOCUS

@NephroP

2 months ago

Extended #VExUS (#eVExUS) 🔗https://t.co/dh1WqSisnD

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NephroPOCUS

@NephroP

2 months ago

#POCUS #echofirst image of the day: Superior vena cava Doppler (component of #eVExUS).

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NephroPOCUS

@NephroP

3 months ago

More on #eVExUS 🔗https://t.co/94D3SmSFb4

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NephroPOCUS

@NephroP

3 months ago

Doppler analogue of the CVP waveform! Internal jugular vein #eVExUS #VExUS #POCUS

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Residente de Crítica

@DailyUrgencias

4 months ago

😍 #eVExUS #VExUS

NephroPOCUS

@NephroP

4 months ago

Thanks so much for the kind words and the opportunity, Dr. Minami. Always great seeing you! Really enjoyed meeting the #CHEST podcast team and the conversation. Short but productive… though it looks like my friend @ArgaizR successfully converted everyone to a portal vein–centric #VExUS believers while I was trying to sneak in some #eVExUS propaganda 😄

NephroP's tweet photo. Thanks so much for the kind words and the opportunity, Dr. Minami. Always great seeing you! Really enjoyed meeting the #CHEST podcast team and the conversation.
Short but productive… though it looks like my friend @ArgaizR successfully converted everyone to a portal vein–centric #VExUS believers while I was trying to sneak in some #eVExUS propaganda 😄

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NephroPOCUS

@NephroP

5 months ago

🤛 I’m all in for #eVExUS, including the femoral vein, especially when the primary veins are unreliable, inaccessible, or just technically difficult to obtain. The original veins in the VExUS framework are anatomically and physiologically distinct, and each gives a different window into venous congestion. The hepatic vein sits closest to the right atrium and tends to mirror right atrial pressure and filling patterns quite faithfully. The portal vein is downstream of the hepatic sinusoids, which buffer the direct transmission of central venous pressure. And the intrarenal (interlobar) veins lie within the renal parenchyma, making them a useful marker of parenchymal congestion from venous hypertension. You wouldn’t capture renal tamponade effect by sampling the main renal vein, which sits outside the parenchyma. One limitation of the femoral vein, though, is that it’s farther from the heart, so its sensitivity for detecting elevated central venous pressure is logically lower, even though the specificity remains high. Consistent with that, a 1996 study showed femoral vein Doppler had a sensitivity of about 46% but a specificity of 94% for elevated right atrial pressure. In other words, a normal waveform doesn’t rule out congestion, but an abnormal one strongly suggests it. Moreover, FV also needs EKG for accurate interpretation. That said, the RUQ is still my go-to area rather than the groin - partly just a specialty-related preference since we don’t typically place femoral catheters. 🔗 https://t.co/Z4tq1Gfcby

NephroP's tweet photo. 🤛

I’m all in for #eVExUS, including the femoral vein, especially when the primary veins are unreliable, inaccessible, or just technically difficult to obtain. The original veins in the VExUS framework are anatomically and physiologically distinct, and each gives a different window into venous congestion. The hepatic vein sits closest to the right atrium and tends to mirror right atrial pressure and filling patterns quite faithfully. The portal vein is downstream of the hepatic sinusoids, which buffer the direct transmission of central venous pressure. And the intrarenal (interlobar) veins lie within the renal parenchyma, making them a useful marker of parenchymal congestion from venous hypertension. You wouldn’t capture renal tamponade effect by sampling the main renal vein, which sits outside the parenchyma.

One limitation of the femoral vein, though, is that it’s farther from the heart, so its sensitivity for detecting elevated central venous pressure is logically lower, even though the specificity remains high. Consistent with that, a 1996 study showed femoral vein Doppler had a sensitivity of about 46% but a specificity of 94% for elevated right atrial pressure. In other words, a normal waveform doesn’t rule out congestion, but an abnormal one strongly suggests it. Moreover, FV also needs EKG for accurate interpretation.

That said, the RUQ is still my go-to area rather than the groin - partly just a specialty-related preference since we don’t typically place femoral catheters.
🔗 https://t.co/Z4tq1Gfcby

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NephroPOCUS

@NephroP

6 months ago

FV Doppler #VExUS #eVExUS

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NephroPOCUS

@NephroP

7 months ago

Real-life case illustrating #eVExUS https://t.co/0gTEbceU02

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NephroPOCUS

@NephroP

7 months ago

#eVExUS is an umbrella concept that includes additional #POCUS parameters to assess venous congestion when the original #VExUS veins - hepatic portal and intrarenal are inaccessible or unreliable. My article linked here summarizes this concept. Future research is needed to validate it across different clinical scenarios and to figure out how best to use it in practice. #Nephpearls #FOAMed 🔗https://t.co/DI4CDjU3me

NephroP's tweet photo. #eVExUS is an umbrella concept that includes additional #POCUS parameters to assess venous congestion when the original #VExUS veins - hepatic portal and intrarenal are inaccessible or unreliable. My article linked here summarizes this concept. Future research is needed to validate it across different clinical scenarios and to figure out how best to use it in practice.
#Nephpearls #FOAMed
🔗https://t.co/DI4CDjU3me

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NephroPOCUS

@NephroP

7 months ago

Formally introducing the concept of extended #VExUS (#eVExUS) #Nephpearls #POCUS #FOAMed 🔗 https://t.co/0T5rylrrXo

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NephroPOCUS

@NephroP

9 months ago

#POCUS quiz of the day ⭕️What view is this? ⭕️What vessel is being sampled? (Doppler waveform) Clue: Helpful in cirrhosis where subxiphoid window is difficult #Nephpearls #eVExUS #FOAMed

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NephroPOCUS

@NephroP

10 months ago

Venous. Arterial spike shouldn't be in diastole (always use EKG when performing #VExUS #eVExUS). Also, this is how arterial waveform looks like 👇

NephroP's tweet photo. Venous. Arterial spike shouldn't be in diastole (always use EKG when performing #VExUS #eVExUS).
Also, this is how arterial waveform looks like 👇 https://t.co/7yTjVFBmHJ

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NephroPOCUS

@NephroP

10 months ago

🔴 Since IJV #Doppler is part of #eVExUS, a quick note on that too -> it should, in theory, resemble the hepatic vein waveform. But head position, probe pressure, and where you place the Doppler sample (especially near the collapse point) can all alter the tracing. Getting a “pretty” waveform isn’t always possible. Simultaneous EKG helps.