Fig. 1

The Venous Excess UltraSound (VExUS) grading system prototypes combining inferior vena cava (IVC) diameter and venous Doppler waveform of the portal, hepatic and interlobular renal veins. Hepatic Doppler is considered mildly abnormal when the systolic (S) component is lower in magnitude than the diastolic (D) component, but still toward the liver while it is considered severely abnormal when the S component is reversed (toward the heart). Portal Doppler is considered mildly abnormal when a variation in the velocities during the cardiac cycle of 30 to < 50% are observed, while is considered severely abnormal when a variation of ≥ 50% is seen. Intra-renal venous Doppler is considered mildly abnormal when it is discontinuous with a systolic (S) and diastolic (D) phase, while is it considered severely abnormal when it is discontinuous with only a diastolic phase seen during the cardiac cycle