A Carotid Doppler Patch Accurately Tracks Stroke Volume Changes During a Preload-Modifying Maneuver in Healthy Volunteers.
A Carotid Doppler Patch Accurately Tracks Stroke Volume Changes During a Preload-Modifying Maneuver in Healthy Volunteers.
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DOI：
10.1097/cce.0000000000000072
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Michard, Frederic
中科院分区：
文献类型：
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作者：
Kenny, Jon-Emile S;Barjaktarevic, Igor;Michard, Frederic
目标：检测瞬时每搏输出量的变化，以改变心脏前负荷的生理基础，为确定前负荷responsibility.Design：概念验证生理学研究设置：研究模拟实验室对象：12名健康志愿者干预：无线连续波多普勒超声贴片被用来测量颈动脉速度时间积分和颈动脉校正流量时间在蹲机动。多普勒补丁测量进行了比较，同时从一个无创的心输出量monitor.MEASUREMENTS和主要结果：从站到蹲，每搏输出量增加了24%，而颈动脉速度时间积分和颈动脉校正流量时间分别增加了32%和9%。从下蹲到站立，每搏输出量减少了13%，而颈动脉速度时间积分和颈动脉校正血流时间分别减少了24%和10%。颈动脉流速时间积分和校正血流时间的变化与每搏输出量的变化密切相关（r 2分别为0.81和0.62）。四象限图发现每搏输出量的变化与颈动脉流速时间积分的变化和校正血流时间的变化之间的一致率为100%。颈动脉速度时间积分的变化大于15%预测每搏输出量的变化大于10%，敏感性为95%，特异性为92%。结论：在健康志愿者中，颈动脉血流速度时间积分和颈动脉校正血流时间均可以用于追踪前负荷调整动作引起的每搏输出量变化，具有较高的敏感性和特异性。
OBJECTIVES: Detecting instantaneous stroke volume change in response to altered cardiac preload is the physiologic foundation for determining preload responsiveness.DESIGN: Proof-of-concept physiology study.SETTING: Research simulation laboratory.SUBJECTS: Twelve healthy volunteers.INTERVENTIONS: A wireless continuous wave Doppler ultrasound patch was used to measure carotid velocity time integral and carotid corrected flow time during a squat maneuver. The Doppler patch measurements were compared with simultaneous stroke volume measurements obtained from a noninvasive cardiac output monitor.MEASUREMENTS AND MAIN RESULTS: From stand to squat, stroke volume increased by 24% while carotid velocity time integral and carotid corrected flow time increased by 32% and 9%, respectively. From squat to stand, stroke volume decreased by 13%, while carotid velocity time integral and carotid corrected flow time decreased by 24% and 10%, respectively. Both changes in carotid velocity time integral and corrected flow time were closely correlated with changes in stroke volume (r 2 = 0.81 and 0.62, respectively). The four-quadrant plot found a 100% concordance rate between changes in stroke volume and both changes in carotid velocity time integral and changes in corrected flow time. A change in carotid velocity time integral greater than 15% predicted a change in stroke volume greater than 10% with a sensitivity of 95% and a specificity of 92%. A change in carotid corrected flow time greater than 4% predicted a change in stroke volume greater than 10% with a sensitivity of 90% and a specificity of 92%.CONCLUSIONS: In healthy volunteers, both carotid velocity time integral and carotid corrected flow time measured by a wireless Doppler patch were useful to track changes in stroke volume induced by a preload-modifying maneuver with high sensitivity and specificity.