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Now that we have several #VExUS #POCUS resources from different educators, I'm going to put them together as a thread and pin to my profile #IMPOCUS #FOAMed
1/ Recent case showing improvement in Doppler indices (helped guiding decongestive therapy in a pt. with minimal symptoms)
2/ What is included in venous excess grading by ultrasound? Landmark paper by @WBeaubien @ThinkingCC @khaycock2 @EMNerd_ @Ad12Andre et al.
theultrasoundjournal.springeropen.com/articles/10.11…
3/ Comprehensive #VExUS tweetorial by @Pocus101
4/ Video with nice graphics by @Wilkinsonjonny @iceman_ex
5/ one of the first (and excellent) videos on #VExUS by @katiewiskar
6/ Mini-tutorial (video) on image acquisition by @ThinkingCC
thinkingcriticalcare.com/2020/02/28/a-v…
7/ @ThinkingCC s blog post including a link to his chapter and podcast.
emcrit.org/emcrit/vexus-s…
8/ The famous #VExUS card by @ArgaizR
9/ Finally, the must-have #POCUS card for all #VExUS enthusiasts from emcrit.org/wp-content/upl…
10/ #POCUS gram from @Wilkinsonjonny
Link: dropbox.com/s/zdocobqylztz…
11/ a must-read article to comprehend the waveforms better #POCUS
pubs.rsna.org/doi/full/10.11…
12/ I'll also attach the #VExUS cases I post to this thread.
Here is a classic congestive case 👇
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#VExUS #POCUS #IMPOCUS #FOAMed

More from @NephroP see all

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NephroPOCUS
@NephroP
Time to follow up on #VExUS #POCUS
Today's images will demonstrate the improvement in congestion with IV diuretic therapy.
#tweetorial
1/ Portal vein - note the pulsatility is ~55% (<30% taken as normal) & the whole waveform is above the baseline now = improvement!! #IMPOCUS
2/ Also note the RAP meter in the above image with arrow pointing to current state.
Below is the side-by-side comparison between the initial #POCUS image and the current one.
3/ Hepatic vein waveform: Note the improvement; arrow points to current state on the RAP meter. #POCUS @ThinkingCC @ArgaizR feel free to comment if you don't agree with the labeling.
Read 10 tweets
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NephroPOCUS
@NephroP
Break from difficult cases but the #VExUS #POCUS series continues....this time #heartfailure with classic images.
#tweetorial
1/ Pulsatile portal v - 100% pulsatility in this case with bidirectional flow. Note the waveform change (on top) with ⬆️ RAP (Tang. et al 2016) #IMPOCUS
2/ How does the normal portal vein Doppler #POCUS look like? - above the baseline (flow towards the transducer) and gently undulates. Like this 👇
3/ Here is the hepatic vein waveform from our #heartfailure patient. Looks biphasic indicating severe congestion like that of portal vein. #POCUS
Note the RAP meter on top from Tang, et al. again.
Read 10 tweets
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NephroPOCUS
@NephroP
Simple-appearing #IMPOCUS scenario but important!
Thread:
1/ Consulted for AKI. Patient: Middle-aged gentleman with significant peripheral edema.
Plan: Let's try diuretic
Oh, may be perform #POCUS
-> IVC looks plump, doesn't appear to collapse 👇 = needs diuretic. #MedEd
2/ but the renal attending likes to do #VExUS
Let's look at portal vein #POCUS
-> Looks great, doesn't seem to indicate congestion
3/ What about the renal vein #POCUS?
Not a great picture due to breathing but seems the waveform is continuous (appears noisy because the gain was increased intentionally) [don't pay attention to RI - its inaccurate]
Read 8 tweets

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