TABLE 4.

Grading table for assessment of Venous congestion with point-of)-care ultrasound VEXUS = venous congestion assessment with ultrasound (adapted with permission from Rola P. et al book “Bedside Ultrasound: a primer for clinical integration” [129])

Parameter	Grade 0	Grade 1	Grade 2	Grade 3	Grade 4
IVC	< 5 mm with respiratory variation	5–9 mm with respiratory variation	10–19 mm with respiratory variation	> 20 mm with respiratory variation	20 mm with minimal or no respiratory variation
Hepatic vein	normal S > D	S < D with antegrade S	S flat or inverted or biphasic trace
Portal vein	< 0.3 pulsatility index	0.3–0.49 pulsatility index	0.5–1.0 pulsatility index
Renal Doppler	Continuous monophasic/ pulsatile flow	Discontinuous biphasic flow	Discontinuous monophasic flow (diastole only)
VEXUS score	IVC grade < 3, HV grade 0, PV grade 0 (RV grade 0)	IVC grade 4, but normal HV/PV/RV patterns	IVC grade 4 with mild flow pattern abnormalities in 2 or more of the following HV/PV/RV	IVC grade 4 with severe flow pattern abnormalities in 2 or more of the following HV/PV/RV

IVC – inferior vena cava, HV – hepatic vein, RV – renal vein, PV – portal vein.