Common Carotid Artery Sonography Versus Transthoracic Echocardiography for Cardiac Output Measurements in Intensive Care Unit Patients

Peng, Qianyi; Zhang, Lina; Ai, Meilin; Li, Li; Hu, Chenghuan; Zhang, Yanxin; Liu, Wei; Feng, Qing; Zou, Yu; Yu-hang, AI

doi:10.1002/jum.14214

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…Peng et al enrolled 148 ICU patients with different primary diseases and compared the correlation between CBF ×10 and CO, showing a correlation coe cient of 0.537 [14]. However, in patients with septic shock, multiple trauma and respiratory failure, the correlation coe cients between CBF and CO were low, attributing to the small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Carotid Blood Flow measured by Ultrasound and cardiac output in Patients undergoing Cardiac Surgery

Zhang

Chen

et al. 2022

Preprint

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In general, cerebral blood flow accounts for 10–15% of cardiac output (CO), of which about 75% was delivered through the carotid arteries. Hence, if carotid blood flow (CBF) is constantly proportional to CO with high reproducibility and reliability, it would be of great value to measure CBF alternatively to CO. The aim of our study was to measure CBF in different cardiac cycles by ultrasound: Systolic carotid blood flow (SCF), Diastolic carotid blood flow (DCF) and Total (systolic and diastolic) carotid blood flow (TCF). And to investigate the direct correlation between CBF and CO. Whether the above correlation persisted when CO < 3.5/min. Patients aged 65 to 80 years old, undergoing elective cardiac surgery were included in this study. CBF and CO were measured by ultrasound and TEE respectively at 5 min, 10 min, and 15 min after induction of anesthesia. For all patients, the correlation coefficients between SCF and CO, TCF and CO were 0.41, 0.32 respectively, which were statistically significant, but not between DCF and CO. When CO < 3.5L/min, there was no significant correlation between either SCF, TCF or DCF and CO. It is suggested that systolic carotid blood flow should be used as a better index to replace CO. However, when the patient's heart function is poor, it is not recommended to use, and the method of direct measurement of CO is essential.

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Section: Discussionmentioning

confidence: 99%

Comparison of Carotid Blood Flow measured by Ultrasound and cardiac output in Patients undergoing Cardiac Surgery

Zhang

Chen

et al. 2022

Preprint

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“…In the study by Peng et al, the overall ICC between the carotid and echocardiographic CO was 0.537, but a subgroup analysis of 14 patients with septic shock showed a weak correlation with an ICC of 0.241. In addition, vasopressor use was not considered 11 . In this study, the mean value of CCA blood flow increased significantly by approximately 16 (SD 20) % when MAP increased after NE administration (Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Carotid measurement is a much simpler technique, which can be performed with more accessibility on unstable patients with limited change of position. The blood flow of the common carotid artery (CCA) has been known to represent CO indirectly, showing moderate agreement with echocardiography 11 . Blood flow changes of the CCA by preload challenges in shock patient had already been reported in several 12 – 15 .…”

Section: Introductionmentioning

confidence: 97%

The effect of norepinephrine on common carotid artery blood flow in septic shock patients

Kim

Kang

et al. 2021

Sci Rep

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This study was designed to evaluate the hemodynamic effect of norepinephrine (NE) on the peak systolic velocity (PSV), diameter, and blood flow of the common carotid artery (CCA) using the point-of-care ultrasound (POCUS) in patients with septic shock. The study involved patients above 18 years old with septic shock. Arterial monitoring, carotid ultrasonography, and transthoracic echocardiography were performed before NE administration (T0). When the mean arterial pressure exceeded 65 mmHg after NE administration (T1), the measurement was repeated. Twenty-four patients (median age 67 [interquartile range: 54–77] years; 42% female) with septic shock were examined in this study. Before (T0) and after (T1) NE administration, the PSV (mean, standard deviation [SD]) changed from 85.3 (21.1) cm/s to 83.5 (23.5) cm/s (p = 0.417); this change was not significant. However, the diameter and blood flow of the CCA increased significantly from 0.6 (0.09) cm and 0.75 (0.27) L/min to 0.66 (0.09) cm and 0.85 (0.27) L/min, respectively (p < 0.001). The diameter of the left ventricular outflow tract (LVOT) remained unchanged, but the velocity time integral of the LVOT increased significantly from 21.7 (4.39) cm to 23.6 (5.14) cm. There was no significant correlation between changes in blood flow of the CCA and changes in cardiac output (coefficient −0.365, p = 0.079). In conclusion, NE increased the diameter and blood flow of the CCA significantly, without changing the PSV in patients with septic shock.

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“…Critical care ultrasound has gained its place as an effective and convenient monitoring tool, which become the "visual stethoscope" of the 21st century [15,16] . Echocardiography is an important part of critical care ultrasound, which allows for an anatomical, functional, and hemodynamic assessment of the heart, and has revolutionized the bedside assessment of ICU patients.…”

Section: Discussionmentioning

confidence: 99%

The characteristics of echocardiography in ICU patients and its relationship with the outcomes

Peng¹,

Liu²,

Zhang³

et al. 2020

Preprint

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Background Echocardiography is widely used for bedside monitoring in ICU. We aimed to describe the characteristics of echocardiography manifestations in different groups of ICU patients, and the association with the outcomes.Methods This is a prospective multiple-center cohort study took place in 17 ICUs in China. A total of 1682 continuous adult patients admitted between August 31, 2017 to February 16, 2019 who had echocardiography performed within 24 hours in ICU were included. The echocardiography was performed and the echocardiography scores were calculated. Data was analyzed and compared between different outcome and primary indication groups.Results The overall 28-day mortality was 15.76%. Left ventricle enlargement and other echocardiogram abnormalities were more common in the non-survivors than the survivors. The EF value was lower, and the decrease in EF value was more frequent in the non-survivors than the survivors. The echocardiography score was significantly higher in the non-survivors than the survivors. The incidence of right ventricle enlargement and EF decrease was high in ICU patients (26.52% and 26.93% respectively). The independent risk factors for 28-day mortality was APACHE II, the length of MV, the length of ICU stay, oxygenation index, right ventricle wall thickening, IVC diameter, IVC variability, and the echocardiography score.Conclusions The incidence of cardiac dysfunction is high in ICU patients. The echocardiography score was significantly higher in the non-survivors than the survivors, and was an independent risk factor for 28-day mortality. Echocardiography is a convenient bedside monitoring method which deserves widely use in ICUs.Trial registration: Chinese Clinical Trial Registry (ChiCTR-DDD-17012391). Registered 2017.08.17. http://www.chictr.org.cn/showprojen.aspx?proj=21127.

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Common Carotid Artery Sonography Versus Transthoracic Echocardiography for Cardiac Output Measurements in Intensive Care Unit Patients

Cited by 14 publications

References 11 publications

Comparison of Carotid Blood Flow measured by Ultrasound and cardiac output in Patients undergoing Cardiac Surgery

Comparison of Carotid Blood Flow measured by Ultrasound and cardiac output in Patients undergoing Cardiac Surgery

The effect of norepinephrine on common carotid artery blood flow in septic shock patients

The characteristics of echocardiography in ICU patients and its relationship with the outcomes

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