title: The diagnostic utility of sonographic carotid flow time in determining volume responsiveness.
abstract: We aimed to predict volume responsiveness and to assess the diagnostic accuracy of carotid flow time (FTc) with the change in hydration status before and after a passive leg raise (PLR) maneuver.
  
  
  
  Participants who presented at a community health fair in a dehydrated state following a prolonged fast while observing the month of Ramadan were recruited. Sonographic FTc measurements were obtained in the semi-Fowler position and after a PLR maneuver while participants were in a fasting state and repeated approximately 3 hours after breaking their fast.
  
  
  
  In total, 123 participants with mean age of 47±14 years, 55% male, were enrolled. Participants had fasted for an average of 16.9 hours and consumed an average of 933 mL between the 2 ultrasound measurements. Mean FTc values were significantly lower in the fasting state compared with the nonfasting state (312±22 vs 345±25milliseconds, P value < .001). Relative increases in FTc following a PLR maneuver demonstrated strong discrimination of volume status (area under the receiver operating curve: 0.86 [95% confidence interval, 0.81-0.91]).
  
  
  
  The use of point-of-care ultrasound to measure FTc may provide a noninvasive alternative to determine fluid status. Percentage change in FTc of ≥5% provides a reliable diagnostic accuracy for predicting fluid status.
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC. Electronic address: shokoohi@gwu.edu.
authors.forename: Hamid
authors.initials: H
authors.lastname: Shokoohi
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Berry
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Murteza
authors.initials: M
authors.lastname: Shahkolahi
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Jackson
authors.initials: J
authors.lastname: King
authors.affiliation: Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO.
authors.forename: Jordan
authors.initials: J
authors.lastname: King
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Salimian
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Ameneh
authors.initials: A
authors.lastname: Poshtmashad
authors.affiliation: Department of Emergency Medicine, The George Washington University, Washington, DC.
authors.forename: Ali
authors.initials: A
authors.lastname: Pourmand
mesh_terms: D002339:Carotid Arteries / Q000502:physiology*; D003422:Critical Care; D003681:Dehydration / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D011446:Prospective Studies; D012372:ROC Curve; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D013318:Stroke Volume; D014463:Ultrasonography
keywords: Carotid Doppler; Carotid flow time; Dehydration; Shock; Ultrasound; Volume status