Carotid systolic flow time with passive leg raise correlates with fluid status changes in patients undergoing dialysis

Antiperovitch, Pavel; Iliescu, Eduard A.; Chan, Barry

doi:10.1016/j.jcrc.2017.02.017

Cited by 23 publications

(23 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four hundred sixty‐five articles were found through the systematic search. Of these, 17 were determined to meet inclusion for the study (Figure ) . A total of 956 patients were included in the identified studies.…”

Section: Resultsmentioning

confidence: 99%

Carotid Ultrasound to Predict Fluid Responsiveness

Beier

Davis

Esener

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives-To perform a systematic review of the accuracy of carotid ultrasound measures in determining volume responsiveness in adults. Methods-We conducted a systematic review of Ovid MEDLINE and Scopus from conception until January 1, 2019. Two independent reviewers used an iterative process to identify relevant articles and abstract information from them. The quality and risk of bias were assessed with the Quality Assessment of Diagnostic Accuracy Studies version 2 tool. Results-We identified 17 relevant articles with 956 patients. The 2 most frequently cited carotid measures of fluid responsiveness were corrected flow time and peak velocity or change in peak velocity with respiration (ΔCDPV). Accordingly, the diagnostic characteristics of corrected flow time in these studies varied widely, with sensitivities from 60% to 73%, specificities from 82% to 92%, and areas under the receiver operating characteristic curves from 0.75 to 0.88. Optimal cutoff values for ΔCDPV ranged from 9.1% to 14%, with areas under the receiver operating characteristic curves from 0.81 to 0.91, sensitivities from 73% to 86%, and specificities from 78% to 86%. Other measures, such as carotid blood flow and carotid diameter, had limited data to support their use. Heterogeneity of the studies prohibited a meta-analysis. Most studies had a moderate risk of bias and high applicability. Conclusions-Preliminary research suggests that carotid ultrasound measures may be useful adjunct measures of fluid status; however, they should not be interpreted as absolute and should be placed in a clinical context. The most welldefined and supported measure currently is ΔCDPV, with cutoffs from 9% to 14%. Corrected flow time shows promise, because of heterogeneity of how this value is measured, an optimal cutoff has not been established.

show abstract

Section: Resultsmentioning

confidence: 99%

Carotid Ultrasound to Predict Fluid Responsiveness

Beier

Davis

Esener

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…In order to determine if a change in preload leads to a change in the duration of flow time, the heart’s afterload and contractility must be constant and the flow time must be corrected for a heart rate [17]. Accordingly, ΔccFT decreases with fluid or blood removal [36, 42, 43], and increases with fluid administration in volume-depleted patients [38, 43, 44]. A number of pilot studies show that ΔccFT also increases after intravenous fluid bolus challenge [33, 35] or PLR [36, 38] in fluid responsive patients.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, ΔccFT decreases with fluid or blood removal [36, 42, 43], and increases with fluid administration in volume-depleted patients [38, 43, 44]. A number of pilot studies show that ΔccFT also increases after intravenous fluid bolus challenge [33, 35] or PLR [36, 38] in fluid responsive patients. Using ultrasonographic CO monitoring [35], pulse contour based analysis [37], or the more widely used, esophageal Doppler-based assessment of SV index to define preload responsiveness [33, 34], fluid responders show significantly higher ΔccFT in comparison to non-responders.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Assessment of the Change in Carotid Corrected Flow Time in Fluid Responsiveness in Undifferentiated Shock

Barjaktarević

Toppen

et al. 2018

Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…Emerging studies, however, demonstrate that large arteries, such as the common carotid artery, are also dynamically compliant, and can predict fl uid responsiveness. [30][31][32] Certainly, ultrasound is operator dependent. [25,26] Standardized parameters, such as corrected flow time, can be calculated using ultrasound, which may help to eliminate differences in image interpretation between providers.…”

Section: Discussionmentioning

confidence: 99%

“…Providers can also use point-of care ultrasound to evaluate carotid systolic flow time. [31] An increase of carotid systolic flow time of greater than thirty milliseconds after PLR was found to correspond to changes in the volume status of patients who had completed a dialysis session. World J Emerg Med, Vol 10, No 4, 2019 Understanding correct fl ow time within common carotid artery…”

Section: Assessment Of Corrected Fl Ow Timementioning

confidence: 93%

The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients

Pourmand¹,

Pyle²,

Yamane³

et al. 2019

World Journal of Emergency Medicine

View full text Add to dashboard Cite

BACKGROUND: Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients. The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes (such as acute pulmonary edema necessitating endotracheal intubation). We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefi t from volume resuscitation. DATA RESOURCES: We performed a search using PubMed, Scopus, and MEDLINE. The following search terms were used: fluid responsiveness, ultrasound, non-invasive, hemodynamic, fluid challenge, and passive leg raise. Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient's cardiovascular ability to respond to intravenous fl uid administration using ultrasound. RESULTS: Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava, common carotid artery, subclavian vein, internal jugular vein, and femoral vein. Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients. CONCLUSION: Ultrasound in combination with passive leg raise is a non-invasive, costand time-effective modality that can be employed to assess volume status and response to fluid resuscitation. Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava, and internal jugular vein. A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.

show abstract

Carotid systolic flow time with passive leg raise correlates with fluid status changes in patients undergoing dialysis

Cited by 23 publications

References 23 publications

Carotid Ultrasound to Predict Fluid Responsiveness

Carotid Ultrasound to Predict Fluid Responsiveness

Ultrasound Assessment of the Change in Carotid Corrected Flow Time in Fluid Responsiveness in Undifferentiated Shock

The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients

Contact Info

Product

Resources

About