title: Noninvasive assessment of hemodynamic response to a fluid challenge using femoral Doppler in critically ill ventilated patients.
abstract: OBJECTIVE
  The purpose of the study is to determine if femoral artery blood flow Doppler parameters can assess cardiac response to a fluid challenge (FC).
  
  
  METHODS
  We prospectively recorded in 52 critically ill ventilated patients' velocity time integral variation (%VTIf) and maximal systolic velocity variation (%Vfmax) derived from femoral Doppler analysis and aortic velocity time integral variation registered on transthoracic echocardiography before and after an FC of 500-mL saline.
  
  
  RESULTS
  According to Pearson coefficient, %Vfmax and %VTIf were found to be positively correlated with aortic velocity time integral variation (r(2) = 0.46 and 0.51, respectively; P < .0001) and were significantly different between responder patients and nonresponders (11% ± 3.4% vs 5.9% ± 4.3% and 14.9% ± 4.2% vs 5.5% ± 5.5%, respectively; P < .0001). Increase of %VTIf 10% or higher and %Vfmax 7% or higher after an FC showed a sensitivity of 80% and 84%, a specificity of 85% and 73%, and an area under the curve of 0.905 and 0.851, respectively, for discriminating responder and nonresponder patients.
  
  
  CONCLUSIONS
  Variation of femoral Doppler parameters before and after FC mirrors cardiac response to fluid loading. This tool could be considered as an alternative to transthoracic echocardiography in case of poor thoracic insonation.
authors.affiliation: Departement Anesthésie-Réanimation, CHU Toulouse, Université Toulouse III Paul Sabatier, Faculté de Médecine Toulouse-Rangueil, EA 4564-MATN, Institut Louis Bugnard (IFR 150), Toulouse F-31000, France. Electronic address: aymericluzi@yahoo.com.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Luzi
authors.forename: Philippe
authors.initials: P
authors.lastname: Marty
authors.forename: Arnaud
authors.initials: A
authors.lastname: Mari
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Conil
authors.forename: Thomas
authors.initials: T
authors.lastname: Geeraerts
authors.forename: Benoît
authors.initials: B
authors.lastname: Lepage
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
authors.forename: Stein
authors.initials: S
authors.lastname: Silva
authors.forename: Vincent
authors.initials: V
authors.lastname: Minville
mesh_terms: D018806:APACHE; D001011:Aorta / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity; D016638:Critical Illness; D004452:Echocardiography; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler
keywords: Cardiac output; Echocardiography; Femoral Doppler; Fluid challenge; Shock