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Demir I, Turktan M, Gulec E, Arslan YK, Ozalevli M. The predictive role of carotid artery flow time for anesthesia-induced hypotension in high-risk elderly patients. J Clin Monit Comput 2024; 38:859-867. [PMID: 38609724 DOI: 10.1007/s10877-024-01145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/25/2024] [Indexed: 04/14/2024]
Abstract
Hypotension induced by general anesthesia is associated with postoperative complications, increased mortality, and morbidity, particularly elderly patients. The aim of this study was to investigate the effectiveness of corrected carotid artery flow time (FTc) for predicting hypotension following anesthesia induction in patients over 65 years old. After faculty ethical committee approval and written informed consent, 138 patients (65 years and older, ASA physical status I-III) who scheduled for elective surgery were included in this study. In the pre-operative anesthesia unit, the carotid artery FTc value was measured by ultrasound and hemodynamic values were recorded. Following anesthesia induction with propofol, hemodynamic data were recorded at 1-minute intervals for 3 min. Measurements were terminated prior to endotracheal intubation, as direct laryngoscopy and endotracheal intubation could cause sympathetic stimulation and hemodynamic changes. Hypotension occurred in 52 patients (37.7%). The preoperative FTc value of the patients who developed hypotension was statistically lower (312.5 ms) than the patients who did not (345.0 ms) (p < 0.001). The area under the ROC curve for carotid artery FTc was 0.93 (95% CI for AUC:0.89-0.97; p < 0.001) with an optimal cut-off of value for predicting post-anesthesia hypotension 333 ms, a sensitivity of 90.4% and a specificity of 84.9%. As a result of the multiple logistic regression model, carotid artery FTc emerged as the sole independent risk factor for hypotension following anesthesia induction. Preoperative carotid artery FTc measurement is a simple, bedside, noninvasive, and reliable method for predicting anesthesia-induced hypotension in elderly patients.
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Affiliation(s)
- Ismail Demir
- Department of Anesthesiology and Reanimation, Cukurova University, Adana, Turkey
| | - Mediha Turktan
- Department of Anesthesiology and Reanimation, Cukurova University, Adana, Turkey.
| | - Ersel Gulec
- Department of Anesthesiology and Reanimation, Cukurova University, Adana, Turkey
| | | | - Mehmet Ozalevli
- Department of Anesthesiology and Reanimation, Cukurova University, Adana, Turkey
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Juri T, Suehiro K, Mori T. Reply to the letter. J Anesth 2024; 38:418. [PMID: 38493424 DOI: 10.1007/s00540-024-03336-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Takashi Juri
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, Osaka, 545-8586, Japan
| | - Koichi Suehiro
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, Osaka, 545-8586, Japan.
| | - Takashi Mori
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, Osaka, 545-8586, Japan
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Juri T, Suehiro K, Mori T. Reply to the letter. J Anesth 2024; 38:294. [PMID: 38407578 DOI: 10.1007/s00540-024-03330-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Takashi Juri
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan
| | - Koichi Suehiro
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan.
| | - Takashi Mori
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan
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Juri T, Suehiro K, Yasuda S, Kimura A, Fujimoto Y, Mori T. Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study. J Anesth 2024; 38:105-113. [PMID: 38172292 DOI: 10.1007/s00540-023-03293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Spinal anesthesia is a standard technique for cesarean delivery; however, it possesses a risk of hypotension. We hypothesised that the changes in the corrected flow time induced by the Trendelenburg position could predict the incidence of hypotension after spinal anesthesia for cesarean delivery. METHODS Patients undergoing elective cesarean delivery under spinal anesthesia were enrolled. Before anesthesia induction, corrected flow time was measured in the supine and Trendelenburg positions (FTc-1 and FTc-2, respectively). Additionally, a percent change in corrected flow time induced by the Trendelenburg position was defined as ΔFTc. The primary endpoint was to investigate the ability of ΔFTc to predict the incidence of spinal anesthesia-induced hypotension until delivery. The receiver operating characteristics curves to assess the ability of FTc-1, FTc-2, and ΔFTc to predict the incidence of hypotension were generated. RESULTS Finally, 40 patients were included, and of those, 26 (65%) developed spinal anesthesia-induced hypotension. The areas under the curve for FTc-1, FTc-2, and ΔFTc were 0.591 (95% CI: 0.424 to 0.743) (P = 0.380), 0.742 (95% CI: 0.579 to 0.867) (P = 0.004), and 0.882 (95% CI: 0.740 to 0.962) (P < 0.001) respectively, indicating ΔFTc as the best predictor among these three parameters. The best threshold for ΔFTc was 6.4% (sensitivity: 80.8% (95% CI: 53.8 to 96.2), specificity: 85.7% (95% CI: 42.9 to 100.0)). CONCLUSIONS This study demonstrated that changes in the corrected carotid flow time induced by the Trendelenburg position could serve as a good predictor of spinal anesthesia-induced hypotension for cesarean delivery.
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Affiliation(s)
- Takashi Juri
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan
| | - Koichi Suehiro
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan.
| | - Shinta Yasuda
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan
| | - Aya Kimura
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan
| | - Yohei Fujimoto
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan
| | - Takashi Mori
- Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan
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Aslanlar E, Alharach CK, Kara İ, Onal O, Aslanlar DA. The Use of End-Tidal CO 2 and Integrated Pulmonary Index to Predict Postspinal Hypotension in Cesarean Section. J Clin Med 2023; 13:85. [PMID: 38202092 PMCID: PMC10779670 DOI: 10.3390/jcm13010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Early diagnosis and treatment of postspinal hypotension (PSH) in obstetric anaesthesia reduces the risk of maternofetal complications. In this study, the effect of EtCO2 and the integrated pulmonary index (IPI) in predicting PSH was investigated. Patients scheduled for cesarean section under spinal anaesthesia were included. The Capnostream 35 respiratory monitor (Medtronic, Inc., Dublin, Ireland) was used for EtCO2 and IPI. PSH developed in 52 (63.4%) of the 82 patients. EtCO2 and IPI values decreased significantly compared with baseline values in patients who developed PSH. There were statistically significant differences in EtCO2 (p = 0.001) and the IPI change (p = 0.045) in patients who developed PSH compared with those who did not. It was found that the EtCO2 difference had an independent effect on predicting PSH (p < 0.05), whereas the IPI difference did not (p > 0.05). One unit decrease in EtCO2 from the baseline increased the risk of PSH by 3.3 times. ROC curve analysis showed that the magnitude of change in EtCO2 was diagnostic for predicting PSH (AUC: 0.90 (0.83-0.97; p < 0.001)). IPI showed no predictive value for postspinal hypotension in cesarean section. However, EtCO2 monitoring, which is non-invasive and real-time monitoring, can be used to predict postspinal hypotension.
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Affiliation(s)
- Emine Aslanlar
- Department of Anesthesiology, Medicine Faculty, Selcuk University, Ardıçlı, Akademi, Celal Bayar St. No. 313, Konya 42250, Turkey; (İ.K.); (O.O.)
| | - Camille Kamel Alharach
- Department of Anesthesiology, Medicine Faculty, Başkent University, Hocacihan Mahallesi Saray Caddesi No. 1, Konya 42080, Turkey;
| | - İnci Kara
- Department of Anesthesiology, Medicine Faculty, Selcuk University, Ardıçlı, Akademi, Celal Bayar St. No. 313, Konya 42250, Turkey; (İ.K.); (O.O.)
| | - Ozkan Onal
- Department of Anesthesiology, Medicine Faculty, Selcuk University, Ardıçlı, Akademi, Celal Bayar St. No. 313, Konya 42250, Turkey; (İ.K.); (O.O.)
| | - Durmuş Ali Aslanlar
- Meram State Hospital, Hacışaban, Yeni Meram St. No. 97, Konya 42090, Turkey;
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Hung KC, Liu CC, Huang YT, Wu JY, Chen JY, Ko CC, Lin CM, Hsing CH, Yew M, Chen IW. Predictive Efficacy of the Perfusion Index for Hypotension following Spinal Anesthesia in Parturient Undergoing Elective Cesarean Section: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:2584. [PMID: 37568947 PMCID: PMC10417716 DOI: 10.3390/diagnostics13152584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
This meta-analysis assessed the predictive efficacy of perfusion index for hypotension following spinal anesthesia (SA) in parturients undergoing elective cesarean section (CS). Electronic databases, including Google Scholar, EMBASE, Cochrane Library, and MEDLINE, were searched from inception to June 2023. The primary outcome was the diagnostic accuracy of the perfusion index in predicting the probability of perioperative hypotension following SA. The review included 12 studies involving 2009 patients, published between 2017 and 2023. The pooled sensitivity and specificity were 0.81 (95% confidence interval (CI) = 0.72-0.87) and 0.75 (95% CI = 0.67-0.82), respectively. Additionally, the pooled area under the curve (AUC) was calculated as 0.84 (95% CI = 0.81-0.87), suggesting a moderate to good accuracy of the diagnostic test. Using Fagan's nomogram plot, the positive likelihood ratio (LR) and negative LR were found to be 3 and 0.26, respectively. The results demonstrated that the perfusion index exhibited an acceptable level of accuracy in predicting perioperative hypotension after spinal anesthesia in parturients undergoing elective CS. These findings highlight the potential value of incorporating a perfusion index as a useful tool for clinicians to integrate into routine clinical practice, which necessitates further large-scale studies for verification.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.)
| | - Chien-Cheng Liu
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung City 82456, Taiwan
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
- School of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70101, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Jen-Yin Chen
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.)
| | - Ching-Chung Ko
- Department of Medical Imaging, Chi Mei Medical Center, Tainan City 71004, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Chien-Ming Lin
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.)
| | - Chung-Hsi Hsing
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.)
- Department of Medical Research, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Ming Yew
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.)
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City 73657, Taiwan
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Feng S, Gu J, Yu C, Liu J, Ni J. Exploring the predictive value of combined ultrasound parameters for spinal anesthesia-induced hypotension in cesarean section: a prospective observational study. BMC Anesthesiol 2023; 23:255. [PMID: 37507678 PMCID: PMC10375731 DOI: 10.1186/s12871-023-02160-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/31/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Prophylactic vasopressor infusion can effectively assist with fluid loading to prevent spinal anesthesia-induced hypotension. However, the ideal dose varies widely among individuals. We hypothesized that hypotension-susceptible patients requiring cesarean section (C-section) could be identified using combined ultrasound parameters to enable differentiated prophylactic medical interventions. METHODS This prospective observational trial was carried out within a regional center hospital for women and children in Sichuan Province, China. Singleton pregnant women undergoing combined spinal-epidural anesthesia for elective C-sections were eligible. Women with contraindications to spinal anesthesia or medical comorbidities were excluded. Velocity time integral (VTI) and left ventricular end-diastolic area (LVEDA) in the supine and left lateral positions were measured on ultrasound before anesthesia. Stroke volume, cardiac output, and the percentage change (%) in each parameter between two positions were calculated. Vital signs and demographic data were recorded. Spinal anesthesia-induced hypotension was defined as a mean arterial pressure decrease of > 20% from baseline. The area under the receiver operating characteristic curve (AUROC) was used to analyze the associations of ultrasound measurements, vital signs, and demographic characteristics with spinal anesthesia-induced hypotension. This exploratory study did not have a predefined outcome; however, various parameter combinations were compared using the AUROC to determine which combined parameters had better predictive values. RESULTS Patients were divided into the normotension (n = 31) and hypotension groups (n = 57). A combination of heart rate (HR), LVEDAs, and VTI% was significantly better at predicting hypotension than was HR (AUROC 0.827 vs. 0.707, P = 0.020) or LVEDAs (AUROC 0.827 vs. 0.711, P = 0.039) alone, but not significantly better than VTI% alone (AUROC 0.827 vs. 0.766, P = 0.098). CONCLUSION The combined parameters of HR and LVEDAs with VTI% may predict spinal anesthesia-induced hypotension more precisely than the single parameters. Future research is necessary to determine whether this knowledge improves maternal and neonatal outcomes. TRIAL REGISTRATION ChiCTR1900025191.
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Affiliation(s)
- Shimiao Feng
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610000, China
| | - Juan Gu
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610000, China
| | - Chao Yu
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610000, China
| | - Jin Liu
- Department of Anesthesiology and Translational Neuroscience Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, 610041, China.
| | - Juan Ni
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610000, China.
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Hung KC, Huang YT, Tsai WW, Tan PH, Wu JY, Huang PY, Liu TH, Chen IW, Sun CK. Diagnostic Efficacy of Carotid Ultrasound for Predicting the Risk of Perioperative Hypotension or Fluid Responsiveness: A Meta-Analysis. Diagnostics (Basel) 2023; 13:2290. [PMID: 37443683 DOI: 10.3390/diagnostics13132290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Despite the acceptance of carotid ultrasound for predicting patients' fluid responsiveness in critical care and anesthesia, its efficacy for predicting hypotension and fluid responsiveness remains unclear in the perioperative setting. Electronic databases were searched from inception to May 2023 to identify observational studies focusing on the use of corrected blood flow time (FTc) and respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak) for assessing the risks of hypotension and fluid responsiveness. Using FTc as a predictive tool (four studies), the analysis yielded a pooled sensitivity of 0.82 (95% confidence interval (CI): 0.72 to 0.89) and specificity of 0.94 (95% CI: 0.88 to 0.97) for the risk of hypotension (area under curve (AUC): 0.95). For fluid responsiveness, the sensitivity and specificity of FTc were 0.79 (95% CI: 0.72 to 0.84) and 0.81 (95% CI: 0.75 to 0.86), respectively (AUC: 0.87). In contrast, the use of ΔVpeak to predict the risk of fluid responsiveness showed a pooled sensitivity of 0.76 (95% CI: 0.63 to 0.85) and specificity of 0.74 (95% CI: 0.66 to 0.8) (AUC: 0.79). The current meta-analysis provides robust evidence supporting the high diagnostic accuracy of FTc in predicting perioperative hypotension and fluid responsiveness, which requires further studies for verification.
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Affiliation(s)
- Kuo-Chuan Hung
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70101, Taiwan
| | - Wen-Wen Tsai
- Department of Neurology, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Ping-Heng Tan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - Ting-Hui Liu
- Department of General Internal Medicine, Chi Mei Medical Center, Tainan City 71004, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City 73657, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung City 82445, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
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Kenny JÉS, Gibbs SO, Johnston D, Yang Z, Hofer LM, Elfarnawany M, Eibl JK, Johnson A, Buecker AJ, Lau VC, Kemp BO. The time cost of physiologically ineffective intravenous fluids in the emergency department: an observational pilot study employing wearable Doppler ultrasound. J Intensive Care 2023; 11:7. [PMID: 36793079 PMCID: PMC9933329 DOI: 10.1186/s40560-023-00655-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Little data exist on the time spent by emergency department (ED) personnel providing intravenous (IV) fluid to 'responsive' versus 'unresponsive' patients. METHODS A prospective, convenience sample of adult ED patients was studied; patients were enrolled if preload expansion was indicated for any reason. Using a novel, wireless, wearable ultrasound, carotid artery Doppler was obtained before and throughout a preload challenge (PC) prior to each bag of ordered IV fluid. The treating clinician was blinded to the results of the ultrasound. IV fluid was deemed 'effective' or 'ineffective' based on the greatest change in carotid artery corrected flow time (ccFT∆) during the PC. The duration, in minutes, of each bag of IV fluid administered was recorded. RESULTS 53 patients were recruited and 2 excluded for Doppler artifact. There were 86 total PCs included in the investigation comprising 81.7 L of administered IV fluid. 19,667 carotid Doppler cardiac cycles were analyzed. Using ccFT∆ ≥ + 7 ms to discriminate 'physiologically effective' from 'ineffective' IV fluid, we observed that 54 PCs (63%) were 'effective', comprising 51.7 L of IV fluid, whereas, 32 (37%) were 'ineffective' comprising 30 L of IV fluid. 29.75 total hours across all 51 patients were spent in the ED providing IV fluids categorized as 'ineffective.' CONCLUSIONS We report the largest-known carotid artery Doppler analysis (i.e., roughly 20,000 cardiac cycles) in ED patients requiring IV fluid expansion. A clinically significant amount of time was spent providing physiologically ineffective IV fluid. This may represent an avenue to improve ED care efficiency.
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Affiliation(s)
- Jon-Émile S. Kenny
- grid.420638.b0000 0000 9741 4533Health Sciences North Research Institute, 56 Walford Road, Sudbury, ON P3E2H3 Canada ,Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada
| | - Stanley O. Gibbs
- Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada
| | - Delaney Johnston
- Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada
| | - Zhen Yang
- Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada
| | - Lisa M. Hofer
- Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada
| | - Mai Elfarnawany
- Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada
| | - Joseph K. Eibl
- grid.420638.b0000 0000 9741 4533Health Sciences North Research Institute, 56 Walford Road, Sudbury, ON P3E2H3 Canada ,Flosonics Medical 325 W. Front Street, Toronto, ON M5V2Y1 Canada ,grid.436533.40000 0000 8658 0974Northern Ontario School of Medicine, 935 Ramsey Lake Road, Sudbury, ON P3E2C6 Canada
| | - Amanda Johnson
- grid.416495.b0000 0004 0383 0587OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637 USA
| | - Anthony J. Buecker
- grid.416495.b0000 0004 0383 0587OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637 USA
| | - Vivian C. Lau
- grid.416495.b0000 0004 0383 0587OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637 USA
| | - Benjamin O. Kemp
- grid.416495.b0000 0004 0383 0587OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637 USA
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A Wireless Ultrasound Patch Detects Mild-to-Moderate Central Hypovolemia during Lower Body Negative Pressure. J Trauma Acute Care Surg 2022; 93:S35-S40. [PMID: 35594422 PMCID: PMC9323554 DOI: 10.1097/ta.0000000000003698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Can a wireless, wearable Doppler ultrasound detect simulated mild hemorrhage during lower body negative pressure? What is the Doppler Shock Index? Read the recent study performed by Kenny et al. @MayoClinic published in @JTraumAcuteSurg #FOAMed We have developed a wireless, wearable Doppler ultrasound system that continuously measures the common carotid artery Doppler pulse. A novel measure from this device, the Doppler shock index, accurately detected moderate-to-severe central blood volume loss in a human hemorrhage model generated by lower body negative pressure. In this analysis, we tested whether the wearable Doppler could identify only mild-to-moderate central blood volume loss.
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