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371959

Usefulness of peak flow variation in peripheral arteries for prediction of fluid responsiveness in critically ill patients compared to stroke volume variation

Article

Last updated: 29 Dec 2024

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Abstract

Background:-The aim of intravenous (IV) fluid load administration is to improve the tissue perfusion through increasing stroke volume (SV) and cardiac  output (COP). Patients in whome COP increased by ≥ 15% are called fluid responders and those account only 50% of hypotensive patients. ]1[ So it is very crucial to assess the fluid status of patients before fluid administration to distinguish between patients who may benefit and those who may not benefit or fluid administration is likely to be harmful in those patients. Objectives: to validate the diagnostic value of peak flow velocity in carotid artery by Doppler ultrasound in comparison to stroke volume variation (SVV) by velocity time integral (VTI) in assessment of fluid responsiveness in critically ill patients. Methods: This study is a prospective cohort study at the critical care department in Beni-Suef  university hospital ,we studied the effect of fluid challenge on 49 critically ill patients with hypotension (MAP<65mmHg). Carotid Doppler peak velocity (CDPV) and VTI measurements were obtained before and after fluid challenge. Fluid challenge responders were defined as patients whose SVV increased more than 10 % after fluid bolus by echocardiography . Results: ΔCDPV correlated significantly with an increase in SVV by VTI after fluid bolus. Area under the receiver-operator characteristic curve (AUC) of CDPV was 0.937 [95% confidence interval (CI) 0.858 – 1.00]. The optimal cut-off point of ΔCDPV for fluid responsiveness was 12.25% with a sensitivity and specificity of 90% and 94.7% respectively. Conclusion: Doppler assessment of carotid peak velocity seems to be a highly feasible and reliable method to predict fluid responsiveness in critically ill patients with hypotension (MAP> 65 mmHg)

DOI

10.21608/jicem.2024.285127.1034

Keywords

Carotid artery Doppler ultrasound, fluid responsiveness, SVV, VTI

Authors

First Name

Mohamed

Last Name

EL kholy

MiddleName

Bakry

Affiliation

Critical care department, Faculty of medicine, Beni-Suef university, Egypt

Email

mmbakry1212@yahoo.com

City

Beni-Suef

Orcid

-

First Name

Ahmed

Last Name

Mohamed

MiddleName

Eid

Affiliation

Critical care department, Faculty of medicine, Beni-Suef university, Egypt

Email

ahmedeid30191810@yahoo.com

City

Beni-Suef

Orcid

-

First Name

Hamdy

Last Name

Saber

MiddleName

Mohammed

Affiliation

Critical care department, Faculty of medicine, Beni-Suef university, Egypt

Email

hamdysaber@hotmail.com

City

Beni-Suef

Orcid

-

First Name

Ahmed

Last Name

Mohamed

MiddleName

Yassien

Affiliation

Critical care department, Faculty of medicine, Beni-Suef university, Egypt

Email

dr.ahmedelsisi@yahoo.com

City

-

Orcid

-

Volume

4

Article Issue

2

Related Issue

49025

Issue Date

2024-06-01

Receive Date

2024-04-25

Publish Date

2024-06-01

Page Start

93

Page End

103

Print ISSN

2812-5452

Online ISSN

2812-5460

Link

https://jicem.journals.ekb.eg/article_371959.html

Detail API

https://jicem.journals.ekb.eg/service?article_code=371959

Order

371,959

Type

Original papers

Type Code

2,351

Publication Type

Journal

Publication Title

The Egyptian Journal of Intensive Care and Emergency Medicine

Publication Link

https://jicem.journals.ekb.eg/

MainTitle

Usefulness of peak flow variation in peripheral arteries for prediction of fluid responsiveness in critically ill patients compared to stroke volume variation

Details

Type

Article

Created At

29 Dec 2024