The capabilities of the VExUS ultrasound scale in predicting acute kidney injury in patients after cardiac surgery

The aim: to evaluate the VExUS scale's ability to identify patients at high risk of developing acute kidney injury (AKI) after cardiac surgery.

Materials and Methods. The study included 69 patients who had undergone cardiac surgery. The average age of the patients was 59 years (range: 50 to 80 years). There were 48 (69.6%) men and 21 (30.4%) women. All patients underwent an ultrasound assessment of venous congestion using the VExUS protocol (assessment of the diameter of the inferior vena cava, Doppler examination of blood flow patterns in the hepatic, portal, and intrarenal veins). The study was conducted before surgery and in the early postoperative period. AKI was diagnosed according to the KDIGO criteria.

Results. AKI developed in 25 patients (36.2%) in the early postoperative period. When comparing groups of patients with and without AKI, statistically significant differences in the distribution of venous congestion grades according to the VExUS scale were detected only in the first 24 hours after surgery (p = 0.036). In a separate analysis, severe venous congestion (VExUS grade 3) was statistically significantly more common in patients with AKI (p = 0.013), whereas using a VExUS cutoff value of grade ≥2, no statistically significant association with the development of AKI was found.

Conclusion. severe venous congestion (VExUS grade 3) detected in the early postoperative period after cardiac surgery was statistically significantly more common in patients with AKI. Assessment of venous congestion using bedside ultrasound using the VExUS scale can be used as an additional method for identifying patients at high risk of developing AKI.

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