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Carotid ultrasound measurements for assessing fluid responsiveness in spontaneously breathing patients: corrected flow time and respirophasic variation in blood flow peak velocity

 D.-H. Kim  ;  S. Shin  ;  N. Kim  ;  T. Choi  ;  S.H. Choi  ;  Y.S. Choi 
 British Journal of Anaesthesia, Vol.121(3) : 541-549, 2018 
Journal Title
 British Journal of Anaesthesia 
Issue Date
Doppler ultrasound ; blood flow velocity ; carotid artery ; fluid therapy ; respiration
BACKGROUND: This study evaluated the ability of two Doppler ultrasound-derived parameters, the carotid corrected flow time (FTc) and respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak), to predict fluid responsiveness in spontaneously breathing patients. METHODS: A total of 53 spontaneously breathing patients were studied before anaesthetic induction for neurosurgery. Carotid FTc, ΔVpeak, and haemodynamic data were measured before and after administration of 6 ml kg-1 colloid. Fluid responsiveness was defined as a 15% or more increase in stroke volume index as assessed by transthoracic echocardiography after the fluid challenge. RESULTS: Twenty-two (42%) patients were fluid responders. The areas under the receiver operating characteristic curves for FTc and ΔVpeak were 0.842 [95% confidence interval (CI) 0.735-0.948, P<0.001] and 0.818 (95% CI: 0.701-0.935, P<0.001), respectively. The optimal cut-off values of FTc and ΔVpeak for fluid responsiveness were 349.4 ms (sensitivity of 72.7%; specificity of 83.9%) and 9.1% (sensitivity of 72.7%; specificity of 87.1%), respectively. The grey zone for FTc was 346.9-361.0 ms and included 28% of the patients, and the grey zone for ΔVpeak was 6.5-10.2% and included 50% of the patients. CONCLUSIONS: Using Doppler ultrasound-derived parameters measured at the carotid artery, FTc predicted fluid responsiveness in spontaneously breathing patients better than ΔVpeak. However, further studies are warranted before these parameters are recommended for clinical use. CLINICAL TRIAL REGISTRATION: NCT 02843477.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
김남오(Kim, Namo) ORCID logo https://orcid.org/0000-0002-0829-490X
김도형(Kim, Do Hyeong) ORCID logo https://orcid.org/0000-0003-2018-8090
신서경(Shin, Seokyung) ORCID logo https://orcid.org/0000-0002-2641-0070
최승호(Choi, Seung Ho) ORCID logo https://orcid.org/0000-0001-8442-4406
최용선(Choi, Yong Seon) ORCID logo https://orcid.org/0000-0002-5348-864X
최태양(Choi, Taeyang) ORCID logo https://orcid.org/0000-0003-1594-7574
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