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Objective <p>Carotid artery Doppler ultrasound, as a non-invasive monitoring method, offers higher clinical utility during cardiopulmonary resuscitation (CPR) compared to invasive techniques. This study aimed to investigate the application of real-time carotid Doppler ultrasound in CPR patients and analyze the predictive efficacy of waveform-derived parameters for return of spontaneous circulation (ROSC).</p> Methods <p>This prospective observational study consecutively enrolled adult patients who underwent CPR in the emergency department of a tertiary hospital in Zhejiang Province between March 2024 and March 2025. ROSC was defined as the first documented confirmation at a scheduled pulse/rhythm check, independent of Doppler findings. Patients were divided into ROSC and non-ROSC groups based on whether ROSC was obtained. Baseline characteristics and carotid Doppler parameters were analyzed to evaluate their prognostic value. Univariate analysis compared baseline characteristics, CPR data, and carotid Doppler parameters between groups. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of statistically significant indicators for ROSC.</p> Results <p>Among 51 patients (23 in the ROSC group, 28 in the non-ROSC group). Significant differences were observed in carotid blood flow parameters between groups, including VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX (all <i>P</i> &lt; 0.05). ROC analysis showed AUC values of 0.811 (VTI), 0.758 (Vmax), 0.727 (Vmin), 0.751 (cMD*) and 0.72 (dv.MAX), with optimal cutoffs of 18.8 87.1,19, 2318 and 8.75, respectively. Because ROSC was adjudicated at scheduled pulse/rhythm checks, the prespecified 60-second Doppler window before documented ROSC may have partially overlapped with spontaneous rather than purely compression-generated flow.</p> Conclusion <p>Carotid Doppler parameters (VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX) significantly differ between ROSC and non-ROSC groups. These parameters may provide objective hemodynamic insights during CPR. However, these findings should be interpreted cautiously because the Doppler window preceding documented ROSC may have partially included ROSC-transition flow; therefore, the results are exploratory and require prospective multicenter validation.</p>

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Predictive value of carotid artery Doppler ultrasound for resuscitation outcomes in patients with cardiac arrest

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月7日

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  • Shuaishuai Zhou,
  • Sa Wang,
  • Shurong Xu,
  • Jue Fang,
  • Rui Zhang,
  • Danping Yan,
  • Yajie Liu,
  • Meiling Wang,
  • Yuwei Wang

摘要

Objective

Carotid artery Doppler ultrasound, as a non-invasive monitoring method, offers higher clinical utility during cardiopulmonary resuscitation (CPR) compared to invasive techniques. This study aimed to investigate the application of real-time carotid Doppler ultrasound in CPR patients and analyze the predictive efficacy of waveform-derived parameters for return of spontaneous circulation (ROSC).

Methods

This prospective observational study consecutively enrolled adult patients who underwent CPR in the emergency department of a tertiary hospital in Zhejiang Province between March 2024 and March 2025. ROSC was defined as the first documented confirmation at a scheduled pulse/rhythm check, independent of Doppler findings. Patients were divided into ROSC and non-ROSC groups based on whether ROSC was obtained. Baseline characteristics and carotid Doppler parameters were analyzed to evaluate their prognostic value. Univariate analysis compared baseline characteristics, CPR data, and carotid Doppler parameters between groups. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of statistically significant indicators for ROSC.

Results

Among 51 patients (23 in the ROSC group, 28 in the non-ROSC group). Significant differences were observed in carotid blood flow parameters between groups, including VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX (all P < 0.05). ROC analysis showed AUC values of 0.811 (VTI), 0.758 (Vmax), 0.727 (Vmin), 0.751 (cMD*) and 0.72 (dv.MAX), with optimal cutoffs of 18.8 87.1,19, 2318 and 8.75, respectively. Because ROSC was adjudicated at scheduled pulse/rhythm checks, the prespecified 60-second Doppler window before documented ROSC may have partially overlapped with spontaneous rather than purely compression-generated flow.

Conclusion

Carotid Doppler parameters (VTI、Vmax、Vmin、TAV、MD*、RI、dv.MAX) significantly differ between ROSC and non-ROSC groups. These parameters may provide objective hemodynamic insights during CPR. However, these findings should be interpreted cautiously because the Doppler window preceding documented ROSC may have partially included ROSC-transition flow; therefore, the results are exploratory and require prospective multicenter validation.