Evidence of the usefulness of VEXUS score in the diagnosis and treatment of the syndrome cardiorenal: a narrative review

Abstract

Cardiorenal syndrome (CRS) includes a spectrum of disorders affecting both the heart and the kidneys in which acute or chronic dysfunction in one organ leads to acute or chronic dysfunction in the other. The use of Point-of-Care ultrasound (POCUS) and specifically the VExUS score seems to play an important role in the detection of venous congestion, being a useful tool to complement the physical examination of the patient, allowing the establishment of a targeted therapeutic approach. CRS is a entity that presents a challenge for the clinician, from the difficulty in establishing the etiology to the need to monitoring and follow-up of the chosen treatment. Point-of-Care ultrasound and specifically the VExUS Score emerged promisingly for the evaluation of patients with kidney injury and congestion. In this context, it makes sense to find the evidence that can guide us towards the integrated use of VExUs in such a complex pathology and common as CRS. A article review was made for systematic reviews, meta-analyses, observational studies, original studies, articles on evidence-based medicine sites published in the last 10 years, in English and Spanish. 43 results were obtained, of which 13 met the inclusion criteria. In conclusion, most of the studies carried out correspond to post-surgical patients, and despite the fact that VExUS is increasingly present in the literature, it is necessary to generate evidence to know if it could be useful to manage, assess and adjust the treatment of our main cohort of patients.

Keywords

• Point-of-Care ultrasound. Acute heart failure. Inferior vena cava. Venous excess ultrasound score. Cardio-Renal syndrome. Acute kidney injury.