PhD Scientific Days 2026

Poster Session 3.R - Cardiovascular Medicine and Research

Femoral Venous Flow Augmented Venous Excess Ultrasound Combined is Able to Predict Volume Status After Elective Cardiac Surgery

Name of the presenter

Marosi, Kamilla

Institute/workplace of the presenter

Semmelweis University Heart and Vascular Center

Authors

Kamilla Marosi¹, Dr. Bálint Lakatos¹, Dr. Bálint Barta¹, Dr. Bernadett Lonkai¹, Dr. Attila Kovács¹, Dr. Endre Németh¹, Prof. Dr. Béla Merkely¹, Dr. Zsolt Turóczi¹
1: Semmelweis University Heart and Vascular Center

Text of the abstract

Introduction: Optimal fluid balance is crucial in the intensive care unit (ICU), yet there is currently no method to unambiguously determine fluid status of patients. VExUS (Venous Excess Ultrasound Score) is a non-invasive ultrasound technique that aims to objectify hypervolemia by combining flow patterns from the hepatic, portal and renal veins. While initial results are promising, its relationship with true fluid status has not yet been demonstrated unequivocally. Moreover, femoral venous flow has been proposed as a good alternative to other venous flow patterns.
Aims: The aim of our study was therefore to investigate the correlation of VExUS with volume status after elective cardiac surgery, and also to assess whether adding the femoral vein to VExUS improves the correlation.
Method: In our retrospective cohort study, patients who underwent elective cardiac surgery with available venous flow data in the electronic health record were selected. Patients with incomplete data or severe comorbidities were excluded. Demographic data, outcome endpoints (extubation, ICU length of stay), and fluid balance at the time of VExUS were analysed. Ultrasound images were reviewed and assigned a severity score in a blinded manner according to VExUS criteria, and combined to calculate VExUS scores with or without femoral vein flow pattern involvement. Results were analysed using Spearman correlation and multivariate linear regression to adjust for confounders.
Results: 57 patients were included. Most were male (80.7%), with a mean age of 61.9±10.1 years. At the time of VExUS, average fluid surplus was 1069±1481ml, and VExUS scores showed a significant correlation with cumulative fluid balance (r=0.72,r²=0.52, p<0.001). Adding femoral venous patterns to VExUS improved the correlation (r=0.74, r²=0.55). The correlation remained significant after adjusting for age, sex, euroscore and operation type. VExUS scores did not correlate with length of ICU or hospital stay, however higher scores resulted in significantly longer mechanical ventilation (p=0.027).
Conclusion: VExUS scores significantly correlated with the fluid balance of patients after cardiac surgery. Adding femoral venous patterns to VExUS slightly improved the correlation, suggesting that femoral venous flow could be used as a substitute if other flow patterns are missing.
This research received no external funding.