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Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study

Measuring fluid responsiveness is important in the management of critically ill patients, with a 10–15% change in cardiac output typically being used to indicate “fluid responsiveness.” Ideally, these changes would be measured noninvasively and peripherally. The aim of this study was to determine ho...

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Autores principales: Munding, Chelsea E., Kenny, Jon-Émile S., Yang, Zhen, Clarke, Geoffrey, Elfarnawany, Mai, Eibl, Andrew M., Eibl, Joseph K., Nalla, Bhanu, Atoui, Rony
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166367/
https://www.ncbi.nlm.nih.gov/pubmed/37168690
http://dx.doi.org/10.1097/CCE.0000000000000914
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author Munding, Chelsea E.
Kenny, Jon-Émile S.
Yang, Zhen
Clarke, Geoffrey
Elfarnawany, Mai
Eibl, Andrew M.
Eibl, Joseph K.
Nalla, Bhanu
Atoui, Rony
author_facet Munding, Chelsea E.
Kenny, Jon-Émile S.
Yang, Zhen
Clarke, Geoffrey
Elfarnawany, Mai
Eibl, Andrew M.
Eibl, Joseph K.
Nalla, Bhanu
Atoui, Rony
author_sort Munding, Chelsea E.
collection PubMed
description Measuring fluid responsiveness is important in the management of critically ill patients, with a 10–15% change in cardiac output typically being used to indicate “fluid responsiveness.” Ideally, these changes would be measured noninvasively and peripherally. The aim of this study was to determine how the common carotid artery (CCA) maximum velocity changes with total circulatory flow when confounding factors are mitigated and determine a value for CCA maximum velocity corresponding to a 10% change in total circulatory flow. DESIGN: Prospective observational pilot study. SETTING: Patients undergoing elective, on-pump coronary artery bypass grafting (CABG) surgery. PATIENTS: Fourteen patients were referred for elective coronary artery bypass grafting surgery. INTERVENTIONS: Cardiopulmonary bypass (CPB) pump flow changes during surgery, as chosen by the perfusionist. MEASUREMENTS: A hands-free, wearable Doppler patch was used for CCA velocity measurements with the aim of preventing user errors in ultrasound measurements. Maximum CCA velocity was determined from the spectrogram acquired by the Doppler patch. CPB flow rates were recorded as displayed on the CPB console, and further measured from the peristaltic pulsation frequency visible on the recorded Doppler spectrograms. MAIN RESULTS: Changes in CCA maximum velocity tracked well with changes in CPB flow. On average, a 13.6% change in CCA maximum velocity was found to correspond to a 10% change in CPB flow rate. CONCLUSIONS: Changes in CCA velocity may be a useful surrogate for determining fluid responsiveness when user error can be mitigated.
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spelling pubmed-101663672023-05-09 Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study Munding, Chelsea E. Kenny, Jon-Émile S. Yang, Zhen Clarke, Geoffrey Elfarnawany, Mai Eibl, Andrew M. Eibl, Joseph K. Nalla, Bhanu Atoui, Rony Crit Care Explor Brief Report Measuring fluid responsiveness is important in the management of critically ill patients, with a 10–15% change in cardiac output typically being used to indicate “fluid responsiveness.” Ideally, these changes would be measured noninvasively and peripherally. The aim of this study was to determine how the common carotid artery (CCA) maximum velocity changes with total circulatory flow when confounding factors are mitigated and determine a value for CCA maximum velocity corresponding to a 10% change in total circulatory flow. DESIGN: Prospective observational pilot study. SETTING: Patients undergoing elective, on-pump coronary artery bypass grafting (CABG) surgery. PATIENTS: Fourteen patients were referred for elective coronary artery bypass grafting surgery. INTERVENTIONS: Cardiopulmonary bypass (CPB) pump flow changes during surgery, as chosen by the perfusionist. MEASUREMENTS: A hands-free, wearable Doppler patch was used for CCA velocity measurements with the aim of preventing user errors in ultrasound measurements. Maximum CCA velocity was determined from the spectrogram acquired by the Doppler patch. CPB flow rates were recorded as displayed on the CPB console, and further measured from the peristaltic pulsation frequency visible on the recorded Doppler spectrograms. MAIN RESULTS: Changes in CCA maximum velocity tracked well with changes in CPB flow. On average, a 13.6% change in CCA maximum velocity was found to correspond to a 10% change in CPB flow rate. CONCLUSIONS: Changes in CCA velocity may be a useful surrogate for determining fluid responsiveness when user error can be mitigated. Lippincott Williams & Wilkins 2023-05-05 /pmc/articles/PMC10166367/ /pubmed/37168690 http://dx.doi.org/10.1097/CCE.0000000000000914 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Brief Report
Munding, Chelsea E.
Kenny, Jon-Émile S.
Yang, Zhen
Clarke, Geoffrey
Elfarnawany, Mai
Eibl, Andrew M.
Eibl, Joseph K.
Nalla, Bhanu
Atoui, Rony
Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study
title Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study
title_full Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study
title_fullStr Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study
title_full_unstemmed Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study
title_short Detecting the Change in Total Circulatory Flow with a Wireless, Wearable Doppler Ultrasound Patch: A Pilot Study
title_sort detecting the change in total circulatory flow with a wireless, wearable doppler ultrasound patch: a pilot study
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166367/
https://www.ncbi.nlm.nih.gov/pubmed/37168690
http://dx.doi.org/10.1097/CCE.0000000000000914
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