Scholarlink

Background <p>Accurately identifying surgical patients who will have an increase in stroke volume following fluid administration remains challenging when utilizing noninvasive bedside methods. This study aims to compare the value of using ultrasound to measure changes in corrected carotid artery flow time (ΔFTc) with that of using invasive measurements of stroke volume variation (ΔSVV) for assessing volume responsiveness in patients under general anesthesia and mechanical ventilation.</p> Methods <p>A total of 91 patients undergoing elective abdominal surgery under general anesthesia were enrolled in this prospective observational study. Under general anesthesia and mechanical ventilation, the ΔFTc was measured using noninvasive bedside ultrasound, and the ΔSVV was measured using invasive hemodynamic monitoring, both before and after fluid administration. Fluid responders were defined as an increase in stroke volume of ≥ 10% after the fluid challenge.</p> Results <p>A total of 47 (54.0%) patients were fluid responders. The ΔFTc was 14.5 ± 8.3 ms for responders and 5.7 ± 4.9 ms for non-responders, while the ΔSVV was 3.3 ± 1.4% for responders and 1.7 ± 0.7% for non-responders. The areas under the receiver operating characteristic curves for ΔFTc and ΔSVV were 0.85 (95% CI 0.77–0.92; <i>P</i> &lt; 0.05) and 0.84 (95% CI 0.75–0.93; <i>P</i> &lt; 0.05), respectively. The optimal cutoff values were 7.03 ms for ΔFTc (sensitivity 91.5%, specificity 69.8%) and 2.85% for ΔSVV (sensitivity 95.6%, specificity 72.6%). A narrower gray zone for ΔFTc, ranging from 7 ms to 12 ms and covering 27 patients, was observed compared with that for ΔSVV, which ranged from 1% to 3% and covered 41 patients.</p> Conclusions <p>Both the ΔFTc and ΔSVV reliably assessed fluid responsiveness in patients undergoing general anesthesia and mechanical ventilation. Noninvasive bedside ultrasound measurement of ΔFTc can serve as an accurate assessment parameter, reflecting the presence of volume responsiveness following rapid fluid administration and showing greater clinical applicability.</p> Trial registration <p><a href="http://www.chictr.org.cn">www.chictr.org.cn</a> (ChiCTR2500101114); registered 21 April 2025.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Comparison of the change in carotid corrected flow time and stroke volume variation for assessing volume responsiveness in general anesthesia patients: a prospective, observational study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月29日

查看全文
  • Yongyong Yang,
  • Min Li,
  • Chenlong Yang,
  • Zhongmou Shi,
  • Huanghui Wu,
  • Guozhong Chen,
  • Lu Chen

摘要

Background

Accurately identifying surgical patients who will have an increase in stroke volume following fluid administration remains challenging when utilizing noninvasive bedside methods. This study aims to compare the value of using ultrasound to measure changes in corrected carotid artery flow time (ΔFTc) with that of using invasive measurements of stroke volume variation (ΔSVV) for assessing volume responsiveness in patients under general anesthesia and mechanical ventilation.

Methods

A total of 91 patients undergoing elective abdominal surgery under general anesthesia were enrolled in this prospective observational study. Under general anesthesia and mechanical ventilation, the ΔFTc was measured using noninvasive bedside ultrasound, and the ΔSVV was measured using invasive hemodynamic monitoring, both before and after fluid administration. Fluid responders were defined as an increase in stroke volume of ≥ 10% after the fluid challenge.

Results

A total of 47 (54.0%) patients were fluid responders. The ΔFTc was 14.5 ± 8.3 ms for responders and 5.7 ± 4.9 ms for non-responders, while the ΔSVV was 3.3 ± 1.4% for responders and 1.7 ± 0.7% for non-responders. The areas under the receiver operating characteristic curves for ΔFTc and ΔSVV were 0.85 (95% CI 0.77–0.92; P < 0.05) and 0.84 (95% CI 0.75–0.93; P < 0.05), respectively. The optimal cutoff values were 7.03 ms for ΔFTc (sensitivity 91.5%, specificity 69.8%) and 2.85% for ΔSVV (sensitivity 95.6%, specificity 72.6%). A narrower gray zone for ΔFTc, ranging from 7 ms to 12 ms and covering 27 patients, was observed compared with that for ΔSVV, which ranged from 1% to 3% and covered 41 patients.

Conclusions

Both the ΔFTc and ΔSVV reliably assessed fluid responsiveness in patients undergoing general anesthesia and mechanical ventilation. Noninvasive bedside ultrasound measurement of ΔFTc can serve as an accurate assessment parameter, reflecting the presence of volume responsiveness following rapid fluid administration and showing greater clinical applicability.

Trial registration

www.chictr.org.cn (ChiCTR2500101114); registered 21 April 2025.