[Measurement of peak velocity variation of common carotid artery with bedside ultrasound to estimate preload in surgery ICU].
OBJECTIVE
To investigate the feasibility and accuracy of bedside ultrasound measuring peak velocity variation of common carotid artery to estimate preload of the patients in surgery ICU.


METHODS
In this prospective cohort study, SICU patients with sinus rhythm and positive pressure ventilation were included. The peak velocity variation in common carotid artery (delta V peak) during each respiratory circle was measured by ICU resident with short-term training and experienced attending songrapher. Stroke volume before and after the fluid challenge was also measured by the experienced songrapher as the gold standard of fluid responsiveness. Then the ROC, feasibility and accuracy of the diagnosis trial were analyzed.


RESULTS
There were 46 patients included. The peak velocity variation of common carotid artery measured by the attending (delta V peak) is highly related with delta SV (r1 = 0.76, P < 0.05). Area under the receiver operating characteristic curve was 0.95 (P < 0.05). The peak velocity variation of common carotid artery (delta V peak) > 12.1% predicted fluid responsiveness with sensitivity of 90.9%, specificity of 83.3%, positive predictive value of 83.3% and negative predictive value of 90.9%. The peak velocity variation of common carotid artery measured by the resident (delta V peak2) were highly related with delta V peak1 (R2 = 0.68, P < 0.05), the AUC was 0.94.


CONCLUSIONS
Measurement of peak velocity variation of common carotid artery with bedside ultrasound can accurately estimate the volume status of the patients in surgery ICU, and it is easy to be performed by the residents of ICU.
Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China.
Wan-Hong
WH
Yin
Yao
Y
Chen
Xiao-Dong
XD
Jin
Yan-Yan
YY
Zuo
Yan
Y
Kang
Bo
B
Wang
Xue-Ying
XY
Zeng
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D001810:Blood Volume; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D019095:Point-of-Care Systems; D011182:Postoperative Care; D011446:Prospective Studies; D012121:Respiration, Artificial; D013318:Stroke Volume / Q000502:physiology; D014463:Ultrasonography