VExUS-ED: Early venous congestion is associated with clinical fluid overload in patients with sepsis
Authors' conclusion
In patients with suspected sepsis, mild venous congestion was independently associated with clinical fluid overload within 72 h.
Study context
- Population
- Adults with suspected sepsis requiring initial fluid resuscitation in the emergency department (ED), Venous Excess Ultrasound (VExUS) within 3 h of ED admission
- Participants
- 103 adults
- Exposure
- VExUS>0 vs VExUS grade 0 at ED admission
- Outcome
- Clinical fluid overload (positive fluid balance plus ≥10% weight gain, pulmonary edema on imaging, or loop diuretic use)
- Follow-up
- 72 h
Methodological detailssingle-centre data-biobank (Acutelines)
- Single-centre data-biobank (Acutelines)
Main finding
As reported in the abstract
Clinical fluid overload within 72 h
Adjusted odds ratio (95% CI)P value
VExUS>0 vs VExUS grade 0
3.66(1.23–11.55)
P = 0.022Abnormal hepatic venous Doppler flow
4.20(1.21–16.38)
P = 0.028- Clinical fluid overload, overall
- 34 (33%)
Observational data: associations, not effects.
Further findings
VExUS grade at ED admission
- Grade 0
- 75%
- Grade 1
- 22%
- Grade ≥ 2
- 3%
Next-day fluid overload (repeated-measures analyses)
- VExUS>0 and abnormal intrarenal venous Doppler flow associated with next-day fluid overload
Original publication
VExUS-ED: Early venous congestion is associated with clinical fluid overload in patients with sepsis. J Crit Care. Published 13 March 2026. doi:10.
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