Carotid peak flow velocity variation as a surrogate of aortic peak flow velocity variation in a pediatric population.

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

BMC Anesthesiology Pub Date : 2025-03-25 DOI:10.1186/s12871-025-03010-4

Federico Cristiani, Juan Pablo Bouchacourt, Juan Riva, Pablo Motta

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引用次数: 0

Abstract

Background: Carotid peak velocity variation (ΔVpeak_Car) is an alternative to aortic peak velocity variation (ΔVpeak_Ao) and has been used in the pediatric population. Children's physiology and anatomy are heterogeneous throughout their growth. For this reason, the predictive value of ΔVpeakCar as a surrogate of ΔVpeakAo can vary at different ages. We hypothesize that the ability of ΔVpeak_Car as a surrogate of ΔVpeak_Ao changes throughout childhood.

Aim: Analyze the concordance and the tracking ability of ΔVpeak_Car and the ΔVpeak_Ao at different stages of development.

Methods: Patients from 0 to 12 years were included. Three groups were defined: under 12 months (G1), between 12 and 60 months (G2), and over 60 months (G3). After anesthesia induction and mechanical ventilation, maximal and minimal aortic and carotid peak flow were measured. ΔVpeak_Ao and ΔVpeak_Car were calculated. Pearson test and simple linear regression were performed. Bland-Altman analysis was performed to determine concordance. 4-quadrant analysis was used, followed by polar analysis of the vectors, to complement the concordance analysis and determine the tracking ability of ΔVpeak_Car to surrogate ΔVpeak_Ao.

Results: Sixty-seven patients were enrolled. 22 (32.4%) patients in G1, 21 (31.3%) in G2 and 24 (35.8%) in G3. The determination coefficient (r) between ΔVpeak_Ao and ΔVpeak_Car in G1 was 0.44 (p < 0.001) with a slope value of 0.61 (SE = 0.11; 95% CI:0.3-0.91). In G2, r² = 0.56 (p < 0.001) with a slope value of 0.59 (SE = 0.14; 95% CI:0.35-0.82); and in G3, r² = 0.85 (p < 0.001) with a slope value of 1.11 (SE = 0.10; 95% CI:0.91-1.31). Bland-Altman analysis showed to G1 a mean bias of -0.37 (LOA - 7.87 to 7.53), to G2 -0.07 (LOA - 7.37 to 7.23) and G3 0.55 (-3.81 to 4.91). Concordance rates were 100% in G3, 95% in G2, and 93% in G1.

Conclusions: ΔVpeak_Car showed good correlation and tracking ability with ΔVpeak_Ao in schoolchildren. In younger children, it was not reliable enough.

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颈动脉峰值血流速度变化作为儿科人群主动脉峰值血流速度变化的替代。

背景：颈动脉峰值速度变化（ΔVpeakCar）是主动脉峰值速度变化（ΔVpeakAo）的替代方法，已用于儿科人群。儿童的生理和解剖学在整个成长过程中都是异质的。因此，ΔVpeakCar作为ΔVpeakAo的替代品的预测价值在不同的年龄会有所不同。我们假设ΔVpeakCar替代ΔVpeakAo的能力在整个童年时期都会发生变化。目的：分析ΔVpeakCar和ΔVpeakAo在不同发展阶段的一致性和跟踪能力。方法：纳入0 ~ 12岁的患者。分为3组：12个月以下（G1）， 12 ~ 60个月（G2）， 60个月以上（G3）。麻醉诱导和机械通气后，测量主动脉和颈动脉最大和最小峰值流量。分别计算ΔVpeakAo和ΔVpeakCar。进行Pearson检验和简单线性回归。采用Bland-Altman分析确定一致性。采用四象限分析，再对载体进行极坐标分析，对一致性分析进行补充，确定ΔVpeakCar对替代ΔVpeakAo的跟踪能力。结果：67例患者入组。G1 22例（32.4%），G2 21例（31.3%），G3 24例（35.8%）。G1组ΔVpeakAo与ΔVpeakCar的决定系数(r)为0.44 (p = 0.56) （p = 0.85）。结论：ΔVpeakCar与小学生ΔVpeakAo具有良好的相关性和跟踪能力。在年龄较小的儿童中，它不够可靠。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Anesthesiology ANESTHESIOLOGY-

CiteScore

3.50

自引率

4.50%

发文量

349

审稿时长

>12 weeks

期刊介绍： BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.