Portable handheld ultrasound for venous excess ultrasound (VExUS) assessment in critical care: Reliability and time efficiency in resident-led examinations
Authors' conclusion
Handheld ultrasound provides reliable VExUS assessment comparable to conventional systems (VExUS grade κ > 0.85), with 40 % faster procedural time (5 vs 8 min, p < 0.0001).
Study context
- Population
- Critically ill ICU patients, VExUS scans by 2 resident trainees after a short VExUS course
- Participants
- 80 patients
- Comparison
- Handheld vs conventional ultrasound for VExUS assessment
- Outcome
- Inter-rater reliability and inter-user reproducibility of the VExUS score
Methodological detailsblinded, paired comparison
- Blinded
- Paired comparison
Performance
As reported in the abstract
Inter-rater VExUS grading reliability
| Test or model | κ | Intraclass correlation coefficient (ICC) |
|---|---|---|
| Handheld | 0.879 | 0.912 |
| Conventional | 0.851 | 0.865 |
κ
Handheld0.879
Conventional0.851
Intraclass correlation coefficient (ICC)
Handheld0.912
Conventional0.865
Further findings
Procedural time
P < 0.0001
| Outcome | Handheld | Conventional | Bias (cm) | P value |
|---|---|---|---|---|
| Agreement handheld vs conventional, IVC diameterRho = 0.92, ICC = 0.98 | 0.037 | |||
| Renal vein concordance | ||||
| κ | 0.55 | 0.653 | ||
| Grading accuracyComparable | P = 0.747 |
Agreement handheld vs conventional, hepatic velocities
- Negligible differences (ICC)
- > 0.96
Image acquisition success
- Overall
- >91 %
- Hepatic/IVC
- 100 %
Original publication
Portable handheld ultrasound for VExUS assessment in critical care: Reliability and time efficiency in resident-led examinations. J Crit Care. Published 20 August 2025. doi:10.
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