Ability of Carotid Corrected Flow Time to Predict Fluid Responsiveness in Patients Mechanically Ventilated Using Low Tidal Volume after Surgery
| Autor: | Sungwon Na, Seungho Jung, Jeongmin Kim, Do-Hyeong Kim, Won Seok Nam |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
flow time medicine.medical_treatment Doppler ultrasound Article fluid therapy 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Internal medicine Hypovolemia medicine Tidal volume Mechanical ventilation Receiver operating characteristic carotid artery business.industry tidal volume 030208 emergency & critical care medicine General Medicine Stroke volume Confidence interval Pulse pressure Cardiology Breathing Medicine medicine.symptom business |
| Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 10, Iss 2676, p 2676 (2021) Volume 10 Issue 12 |
| ISSN: | 2077-0383 |
| Popis: | Predicting fluid responsiveness in patients under mechanical ventilation with low tidal volume (VT) is challenging. This study evaluated the ability of carotid corrected flow time (FTc) assessed by ultrasound for predicting the fluid responsiveness during low VT ventilation. Patients under postoperative mechanical ventilation and clinically diagnosed with hypovolemia were enrolled. Carotid FTc and pulse pressure variation (PPV) were measured at VT of 6 and 10 mL/kg predicted body weight (PBW). FTc was calculated using both Bazett’s (FTcB) and Wodey’s (FTcW) formulas. Fluid responsiveness was defined as a ≥15% increase in the stroke volume index assessed by FloTrac/Vigileo monitor after administration of 8 mL/kg of balanced crystalloid. Among 36 patients, 16 (44.4%) were fluid responders. The areas under the receiver operating characteristic curves (AUROCs) for the FTcB at VT of 6 and 10 mL/kg PBW were 0.897 (95% confidence interval [95% CI]: 0.750–0.973) and 0.895 (95% CI: 0.748–0.972), respectively. The AUROCs for the FTcW at VT of 6 and 10 mL/kg PBW were 0.875 (95% CI: 0.722–0.961) and 0.891 (95% CI: 0.744–0.970), respectively. However, PPV at VT of 6 mL/kg PBW (AUROC: 0.714, 95% CI: 0.539–0.852) showed significantly lower accuracy than that of PPV at VT of 10 mL/kg PBW (AUROC: 0.867, 95% CI: 0.712–0.957 p = 0.034). Carotid FTc can predict fluid responsiveness better than PPV during low VT ventilation. However, further studies using automated continuous monitoring system are needed before its clinical use. |
| Databáze: | OpenAIRE |
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