Comparing Changes in Carotid Flow Time and Stroke Volume Induced by Passive Leg Raising
| Autor: | Juan Guardiola, Jason Mann, Rodrigo Cavallazzi, Mohamed Saad, Paul E. Marik, Bilal Jalil, Karim El-Kersh, Patton Thompson |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Critical Illness Posture Fluid responsiveness Hemodynamics 030204 cardiovascular system & hematology Likelihood ratios in diagnostic testing 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Prospective Studies Aged Receiver operating characteristic business.industry Ultrasound Stroke Volume 030208 emergency & critical care medicine General Medicine Stroke volume Middle Aged Surgery Intensive Care Units Carotid Arteries Ultrasonography Doppler Pulsed Carotid flow Cardiology Arterial line Female business Blood Flow Velocity |
| Zdroj: | The American Journal of the Medical Sciences. 355:168-173 |
| ISSN: | 0002-9629 |
| DOI: | 10.1016/j.amjms.2017.09.006 |
| Popis: | Background Determining volume responsiveness in critically ill patients is challenging. We sought to determine if passive leg raise (PLR) induced changes in pulsed wave Doppler of the carotid artery flow time could predict fluid responsiveness in critically ill patients. Materials and Methods Medical intensive care unit patients ≥18 years old with a radial arterial line and FloTrac/Vigileo monitor in place were enrolled. Pulsed wave Doppler of the carotid artery was performed to measure the change in carotid flow time (CFTC) in response to a PLR. Patients were categorized as fluid responders if stroke volume increased by ≥15% on a Vigileo monitor. The main outcome measure was the accuracy of CFTC to detect a change in response to a PLR. We also calculated the percentage increase in CFTC that could predict fluid responsiveness. Results We enrolled 22 patients. Using an increase of ≥24.6% in the CFTC in response to PLR to predict fluid responsiveness there was a sensitivity of 60%, specificity of 92%, positive likelihood ratio of 7.2, negative likelihood ratio of 0.4, positive predictive value of 86%, negative predictive value of 73% and receiver operating characteristic of 0.75 (95% CI: 0.54-0.96). Conclusions CFTC performs well compared to stroke volume measurements on a Vigileo monitor. The use of CFTC is highlighted in resource-limited environments and when time limits the use of other methods. CFTc should be validated in a larger study with more operators against a variety of hemodynamic monitors. |
| Databáze: | OpenAIRE |
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