The diagnostic utility of sonographic carotid flow time in determining volume responsiveness.

Autor: Shokoohi H; Department of Emergency Medicine, The George Washington University, Washington, DC. Electronic address: shokoohi@gwu.edu., Berry GW; Department of Emergency Medicine, The George Washington University, Washington, DC., Shahkolahi M; Department of Emergency Medicine, The George Washington University, Washington, DC., King J; Department of Emergency Medicine, The George Washington University, Washington, DC., King J; Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO., Salimian M; Department of Emergency Medicine, The George Washington University, Washington, DC., Poshtmashad A; Department of Emergency Medicine, The George Washington University, Washington, DC., Pourmand A; Department of Emergency Medicine, The George Washington University, Washington, DC.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2017 Apr; Vol. 38, pp. 231-235. Date of Electronic Publication: 2016 Nov 09.
DOI: 10.1016/j.jcrc.2016.10.025
Abstrakt: Objective: We aimed to predict volume responsiveness and to assess the diagnostic accuracy of carotid flow time (FTc) with the change in hydration status before and after a passive leg raise (PLR) maneuver.
Methods: Participants who presented at a community health fair in a dehydrated state following a prolonged fast while observing the month of Ramadan were recruited. Sonographic FTc measurements were obtained in the semi-Fowler position and after a PLR maneuver while participants were in a fasting state and repeated approximately 3 hours after breaking their fast.
Results: In total, 123 participants with mean age of 47±14 years, 55% male, were enrolled. Participants had fasted for an average of 16.9 hours and consumed an average of 933 mL between the 2 ultrasound measurements. Mean FTc values were significantly lower in the fasting state compared with the nonfasting state (312±22 vs 345±25milliseconds, P value < .001). Relative increases in FTc following a PLR maneuver demonstrated strong discrimination of volume status (area under the receiver operating curve: 0.86 [95% confidence interval, 0.81-0.91]).
Conclusions: The use of point-of-care ultrasound to measure FTc may provide a noninvasive alternative to determine fluid status. Percentage change in FTc of ≥5% provides a reliable diagnostic accuracy for predicting fluid status.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: