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Kerrebijn I, Atwi S, Elfarnawany M, Eibl AM, Eibl JK, Taylor JL, Kim CH, Johnson BD, Kenny JÉS. The correlation between carotid artery Doppler and stroke volume during central blood volume loss and resuscitation. Acute Crit Care 2024; 39:162-168. [PMID: 38476069 PMCID: PMC11002613 DOI: 10.4266/acc.2023.01095] [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: 08/23/2023] [Revised: 12/14/2023] [Accepted: 01/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Using peripheral arteries to infer central hemodynamics is common among hemodynamic monitors. Doppler ultrasound of the common carotid artery has been used in this manner with conflicting results. We investigated the relationship between changing common carotid artery Doppler measures and stroke volume (SV), hypothesizing that more consecutively-averaged cardiac cycles would improve SV-carotid Doppler correlation. METHODS Twenty-seven healthy volunteers were recruited and studied in a physiology laboratory. Carotid artery Doppler pulse was measured with a wearable, wireless ultrasound during central hypovolemia and resuscitation induced by a stepped lower body negative pressure protocol. The change in maximum velocity time integral (VTI) and corrected flow time of the carotid artery (ccFT) were compared with changing SV using repeated measures correlation. RESULTS In total, 73,431 cardiac cycles were compared across 27 subjects. There was a strong linear correlation between changing SV and carotid Doppler measures during simulated hemorrhage (repeated-measures linear correlation [Rrm ]=0.91 for VTI; 0.88 for ccFT). This relationship improved with larger numbers of consecutively-averaged cardiac cycles. For ccFT, beyond four consecutively-averaged cardiac cycles the correlation coefficient remained strong (i.e., Rrm of at least 0.80). For VTI, the correlation coefficient with SV was strong for any number of averaged cardiac cycles. For both ccFT and VTI, Rrm remained stable around 25 consecutively-averaged cardiac cycles. CONCLUSIONS There was a strong linear correlation between changing SV and carotid Doppler measures during central blood volume loss. The strength of this relationship was dependent upon the number of consecutively-averaged cardiac cycles.
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Affiliation(s)
| | | | | | - Andrew M. Eibl
- Flosonics Medical, Toronto, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
| | - Joseph K. Eibl
- Flosonics Medical, Toronto, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
- Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Jenna L. Taylor
- Human Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Chul-Ho Kim
- Human Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Bruce D. Johnson
- Human Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Jon-Émile S. Kenny
- Flosonics Medical, Toronto, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
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Kerrebijn I, Munding CE, Horner C, Atwi S, Elfarnawany M, Eibl AM, Eibl JK, Taylor JL, Kim CH, Johnson BD, Kenny JÉS. The Correlation between Carotid Artery Corrected Flow Time and Velocity Time Integral during Central Blood Volume Loss and Resuscitation. J Med Ultrasound 2023; 31:309-313. [PMID: 38264586 PMCID: PMC10802870 DOI: 10.4103/jmu.jmu_80_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/18/2023] [Accepted: 09/01/2023] [Indexed: 01/25/2024] Open
Abstract
Background Doppler ultrasound of the common carotid artery is used to infer central hemodynamics. For example, change in the common carotid artery corrected flow time (ccFT) and velocity time integral (VTI) are proposed surrogates of changing stroke volume. However, conflicting data exist which may be due to inadequate beat sample size and measurement variability - both intrinsic to handheld systems. In this brief communication, we determined the correlation between changing ccFT and carotid VTI during progressively severe central blood volume loss and resuscitation. Methods Measurements were obtained through a novel, wireless, wearable Doppler ultrasound system. Sixteen participants (ages of 18-40 years with no previous medical history) were studied across 25 lower body-negative pressure protocols. Relationships were assessed using repeated-measures correlation regression models. Results In total, 33,110 cardiac cycles comprise this analysis; repeated-measures correlation showed a strong, linear relationship between ccFT and VTI. The strength of the ccFT-VTI relationship was dependent on the number of consecutively averaged cardiac cycles (R1 cycle = 0.70, R2 cycles = 0.74, and R10 cycles = 0.81). Conclusions These results positively support future clinical investigations employing common carotid artery Doppler as a surrogate for central hemodynamics.
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Affiliation(s)
| | | | | | | | | | - Andrew M. Eibl
- Flosonics Medical, Toronto, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
| | - Joseph K. Eibl
- Flosonics Medical, Toronto, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
- Northern Ontario School of Medicine, Sudbury, ON, Canada
| | - Jenna L. Taylor
- Department of Cardiovascular Diseases, Human Integrative and Environmental Physiology Laboratory, Mayo Clinic, Rochester, MN, USA
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Chul Ho Kim
- Department of Cardiovascular Diseases, Human Integrative and Environmental Physiology Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Bruce D. Johnson
- Department of Cardiovascular Diseases, Human Integrative and Environmental Physiology Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Jon-Émile S. Kenny
- Flosonics Medical, Toronto, ON, Canada
- Health Sciences North Research Institute, Sudbury, ON, Canada
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