Figure 6.

Venous excess Doppler ultrasound grading. When the diameter of IVC is more than 2 cm, 3 grades of congestion are defined based on the severity of abnormalities on hepatic, portal, and intrarenal venous Doppler. Hepatic vein Doppler is considered mildly abnormal when the S wave is smaller than the D wave, but still below the baseline; it is considered severely abnormal when the S wave is reversed. Portal vein Doppler is considered mildly abnormal when the pulsatility is 30%-50%, and severely abnormal when it is ≥50%. ∗Points of pulsatility measurement. Intrarenal vein Doppler is mildly abnormal when it is pulsatile with distinct S and D components, and severely abnormal when it is monophasic with a D-only pattern. This figure was adapted from NephroPOCUS.com with permission. Abbreviations: IVC, inferior vena cava; VExUS, venous excess Doppler ultrasound.