{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:49:08Z","timestamp":1792478948210,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The Venous Excess Ultrasound Score (VExUS) assesses venous congestion using point\u2010of\u2010care ultrasound. While validated to predict acute kidney injury, its relationship with cumulative fluid balance and clinical edema remains unclear. This study aimed to evaluate these associations 72\u2009hours after intensive care unit (ICU) admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This analytical observational cohort study included adult ICU patients with Foley catheters inserted at admission for fluid balance quantification. Patients on dialysis or with cirrhosis or abdominal hypertension were excluded. The correlation between cumulative fluid balance, edema clinical grade, and VExUS grade was analyzed. Multivariate analysis identified factors associated with significant venous congestion (VExUS grade\u2009\u22652), with statistical significance set at <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 123 patients were included, with a mean age of 60\u2009years (SD \u00b119.2); 59.3% were male. Venous congestion (VExUS grade\u2009\u22651) was observed in 36.5% of patients, despite an average cumulative fluid balance of +0.88\u2009L. Each liter of positive cumulative fluid balance increased the risk of significant congestion (VExUS grade \u22652) by 31% (OR\u2009=\u20091.31; 95% CI: 1.07\u20131.60). The correlation between clinical edema (Godet scale) and VExUS grade was weak (Spearman rho\u2009=\u20090.27), and clinical edema was not associated with significant congestion (OR\u2009=\u20093.22; 95% CI: 0.77\u201313.56).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In ICU patients, fluid overload is an early contributor to significant venous congestion (VExUS grade \u22652) but does not correlate with clinical edema grades, highlighting the limitations of clinical edema in assessing venous congestion.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16709","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T09:12:31Z","timestamp":1747386751000},"page":"1545-1554","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Relationship Between Cumulative Fluid Balance and the Degree of Venous Congestion According to <scp>VExUS<\/scp> Score in Critically Ill Patients in a General Intensive Care Unit"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9148-1289","authenticated-orcid":false,"given":"Carmelo Jos\u00e9","family":"Espinosa\u2010Almanza","sequence":"first","affiliation":[{"name":"Docente Auxiliar Departamento de Medicina Interna, Facultad de Medicina Universidad Nacional de Colombia  Bogot\u00e1 Colombia"},{"name":"Hospital Universitario Nacional de Colombia Grupo de Investigaci\u00f3n en Cuidados Intensivos de la Universidad Nacional de Colombia (GICI\u2010UN)  Bogot\u00e1 Colombia"},{"name":"Universidad Nacional de Colombia Grupo de Inter\u00e9s en Ultrasonido Enfocado HUN\u2010UNAL  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4509-6195","authenticated-orcid":false,"given":"H\u00e9ctor Andr\u00e9s","family":"Ruiz\u2010\u00c1vila","sequence":"additional","affiliation":[{"name":"Hospital Universitario Nacional de Colombia 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Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0567-0241","authenticated-orcid":false,"given":"Estivalis","family":"Acosta\u2010Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Colombia Grupo de Inter\u00e9s en Ultrasonido Enfocado HUN\u2010UNAL  Bogot\u00e1 Colombia"},{"name":"Hospital Universitario Nacional de Colombia Unidad de Cuidados Intensivos  Bogot\u00e1 DC 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