Integrating VTI and VExUS for Individualized Fluid Management

Integrating VTI and VExUS for Individualized Fluid Management
  • Dr. Amr Abouelela — Consultant Intensivist at Al Qassimi Hospital, EHS, Sharjah, and a former Professor of Critical Care Medicine at Alexandria University

Critical Care

Bedside ultrasound helps clinicians individualize fluid resuscitation by assessing both fluid responsiveness and fluid tolerance. Left ventricular outflow tract velocity-time integral (LVOT VTI) can help assess changes in stroke volume after a fluid challenge, while venous excess ultrasound (VExUS) evaluates systemic venous congestion using IVC size and hepatic, portal, and renal venous Doppler patterns. Lung ultrasound identifies B-lines suggestive of pulmonary congestion. Integrating these findings with clinical status helps guide fluid administration, reassessment, and avoidance of fluid overload in critically ill patients.