Irene W Y Ma, Joshua D Caplin, Aftab Azad, Christina Wilson, Michael A Fifer, Aranya Bagchi, Andrew S Liteplo, Vicki E Noble
{"title":"颈动脉血流和校正颈动脉血流时间与有创心输出量测量的相关性。","authors":"Irene W Y Ma, Joshua D Caplin, Aftab Azad, Christina Wilson, Michael A Fifer, Aranya Bagchi, Andrew S Liteplo, Vicki E Noble","doi":"10.1186/s13089-017-0065-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Non-invasive measures that can accurately estimate cardiac output may help identify volume-responsive patients. This study seeks to compare two non-invasive measures (corrected carotid flow time and carotid blood flow) and their correlations with invasive reference measurements of cardiac output. Consenting adult patients (n = 51) at Massachusetts General Hospital cardiac catheterization laboratory undergoing right heart catheterization between February and April 2016 were included. Carotid ultrasound images were obtained concurrently with cardiac output measurements, obtained by the thermodilution method in the absence of severe tricuspid regurgitation and by the Fick oxygen method otherwise. Corrected carotid flow time was calculated as systole time/√cycle time. Carotid blood flow was calculated as π × (carotid diameter)<sup>2</sup>/4 × velocity time integral × heart rate. Measurements were obtained using a single carotid waveform and an average of three carotid waveforms for both measures.</p><p><strong>Results: </strong>Single waveform measurements of corrected flow time did not correlate with cardiac output (ρ = 0.25, 95% CI -0.03 to 0.49, p = 0.08), but an average of three waveforms correlated significantly, although weakly (ρ = 0.29, 95% CI 0.02-0.53, p = 0.046). Carotid blood flow measurements correlated moderately with cardiac output regardless of if single waveform or an average of three waveforms were used: ρ = 0.44, 95% CI 0.18-0.63, p = 0.004, and ρ = 0.41, 95% CI 0.16-0.62, p = 0.004, respectively.</p><p><strong>Conclusions: </strong>Carotid blood flow may be a better marker of cardiac output and less subject to measurements issues than corrected carotid flow time.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0065-0","citationCount":"36","resultStr":"{\"title\":\"Correlation of carotid blood flow and corrected carotid flow time with invasive cardiac output measurements.\",\"authors\":\"Irene W Y Ma, Joshua D Caplin, Aftab Azad, Christina Wilson, Michael A Fifer, Aranya Bagchi, Andrew S Liteplo, Vicki E Noble\",\"doi\":\"10.1186/s13089-017-0065-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Non-invasive measures that can accurately estimate cardiac output may help identify volume-responsive patients. This study seeks to compare two non-invasive measures (corrected carotid flow time and carotid blood flow) and their correlations with invasive reference measurements of cardiac output. Consenting adult patients (n = 51) at Massachusetts General Hospital cardiac catheterization laboratory undergoing right heart catheterization between February and April 2016 were included. Carotid ultrasound images were obtained concurrently with cardiac output measurements, obtained by the thermodilution method in the absence of severe tricuspid regurgitation and by the Fick oxygen method otherwise. Corrected carotid flow time was calculated as systole time/√cycle time. Carotid blood flow was calculated as π × (carotid diameter)<sup>2</sup>/4 × velocity time integral × heart rate. Measurements were obtained using a single carotid waveform and an average of three carotid waveforms for both measures.</p><p><strong>Results: </strong>Single waveform measurements of corrected flow time did not correlate with cardiac output (ρ = 0.25, 95% CI -0.03 to 0.49, p = 0.08), but an average of three waveforms correlated significantly, although weakly (ρ = 0.29, 95% CI 0.02-0.53, p = 0.046). Carotid blood flow measurements correlated moderately with cardiac output regardless of if single waveform or an average of three waveforms were used: ρ = 0.44, 95% CI 0.18-0.63, p = 0.004, and ρ = 0.41, 95% CI 0.16-0.62, p = 0.004, respectively.</p><p><strong>Conclusions: </strong>Carotid blood flow may be a better marker of cardiac output and less subject to measurements issues than corrected carotid flow time.</p>\",\"PeriodicalId\":46598,\"journal\":{\"name\":\"Critical Ultrasound Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2017-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1186/s13089-017-0065-0\",\"citationCount\":\"36\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Ultrasound Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s13089-017-0065-0\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/4/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Ultrasound Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13089-017-0065-0","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/4/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 36
摘要
背景:可以准确估计心输出量的无创测量方法可能有助于识别容量反应性患者。本研究旨在比较两种非侵入性测量方法(校正颈动脉血流时间和颈动脉血流量)及其与有创性心输出量参考测量的相关性。纳入2016年2月至4月在马萨诸塞州总医院心导管实验室接受右心导管插入术的成年患者(n = 51)。颈动脉超声图像与心输出量测量同时获得,在无严重三尖瓣反流时采用热稀释法获得,否则采用Fick氧法获得。校正后的颈动脉血流时间计算为收缩时间/√周期时间。颈动脉血流量计算为π ×(颈动脉直径)2/4 ×速度时间积分×心率。使用单个颈动脉波形和两个测量的三个颈动脉波形的平均值获得测量结果。结果:校正血流时间的单波形测量与心输出量无相关性(ρ = 0.25, 95% CI -0.03 ~ 0.49, p = 0.08),但三种波形的平均值相关性虽弱,但显著相关(ρ = 0.29, 95% CI 0.02 ~ 0.53, p = 0.046)。颈动脉血流量测量与心输出量中度相关,无论使用单一波形还是三种波形的平均值:ρ = 0.44, 95% CI 0.18-0.63, p = 0.004; ρ = 0.41, 95% CI 0.16-0.62, p = 0.004。结论:颈动脉血流量可能是一个更好的心输出量的标志,并且比校正后的颈动脉血流量时间更少受到测量问题的影响。
Correlation of carotid blood flow and corrected carotid flow time with invasive cardiac output measurements.
Background: Non-invasive measures that can accurately estimate cardiac output may help identify volume-responsive patients. This study seeks to compare two non-invasive measures (corrected carotid flow time and carotid blood flow) and their correlations with invasive reference measurements of cardiac output. Consenting adult patients (n = 51) at Massachusetts General Hospital cardiac catheterization laboratory undergoing right heart catheterization between February and April 2016 were included. Carotid ultrasound images were obtained concurrently with cardiac output measurements, obtained by the thermodilution method in the absence of severe tricuspid regurgitation and by the Fick oxygen method otherwise. Corrected carotid flow time was calculated as systole time/√cycle time. Carotid blood flow was calculated as π × (carotid diameter)2/4 × velocity time integral × heart rate. Measurements were obtained using a single carotid waveform and an average of three carotid waveforms for both measures.
Results: Single waveform measurements of corrected flow time did not correlate with cardiac output (ρ = 0.25, 95% CI -0.03 to 0.49, p = 0.08), but an average of three waveforms correlated significantly, although weakly (ρ = 0.29, 95% CI 0.02-0.53, p = 0.046). Carotid blood flow measurements correlated moderately with cardiac output regardless of if single waveform or an average of three waveforms were used: ρ = 0.44, 95% CI 0.18-0.63, p = 0.004, and ρ = 0.41, 95% CI 0.16-0.62, p = 0.004, respectively.
Conclusions: Carotid blood flow may be a better marker of cardiac output and less subject to measurements issues than corrected carotid flow time.