| Title |
Respiratory variation in carotid peak systolic velocity predicts volume responsiveness in mechanically ventilated patients with septic shock: a prospective cohort study
|
|---|---|
| Published in |
The Ultrasound Journal, June 2015
|
| DOI | 10.1186/s13089-015-0029-1 |
| Pubmed ID | |
| Authors |
Miguel Á Ibarra-Estrada, José A López-Pulgarín, Julio C Mijangos-Méndez, José L Díaz-Gómez, Guadalupe Aguirre-Avalos |
| Abstract |
The evaluation of fluid responsiveness in patients with hemodynamic instability remains to be challenging. This investigation aimed to determine whether respiratory variation in carotid Doppler peak velocity (ΔCDPV) predicts fluid responsiveness in patients with septic shock and lung protective mechanical ventilation with a tidal volume of 6 ml/kg. We performed a prospective cohort study at an intensive care unit, studying the effect of 59 fluid challenges on 19 mechanically ventilated patients with septic shock. Pre-fluid challenge ΔCDPV and other static or dynamic measurements were obtained. Fluid challenge responders were defined as patients whose stroke volume index increased more than 15 % on transpulmonary thermodilution. The area under the receiver operating characteristic curve (AUROC) was compared for each predictive parameter. Fluid responsiveness rate was 51 %. The ΔCDPV had an AUROC of 0.88 (95 % confidence interval (CI) 0.77-0.95); followed by stroke volume variation (0.72, 95 % CI 0.63-0.88), passive leg raising (0.69, 95 % CI 0.56-0.80), and pulse pressure variation (0.63, 95 % CI 0.49-0.75). The ΔCDPV was a statistically significant superior predictor when compared with the other parameters. Sensitivity, specificity, and positive and negative predictive values were also the highest for ΔCDPV, with an optimal cutoff at 14 %. There was good correlation between ΔCDPV and SVI increment after the fluid challenge (r = 0.84; p < 0.001). ΔCDPV can be more accurate than other methods for assessing fluid responsiveness in patients with septic shock receiving lung protective mechanical ventilation. ΔCDPV also has a high correlation with SVI increase after fluid challenge. |
X Demographics
The data shown below were collected from the profiles of 45 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 11 | 24% |
| Spain | 4 | 9% |
| Ecuador | 2 | 4% |
| Canada | 2 | 4% |
| Malaysia | 1 | 2% |
| Norway | 1 | 2% |
| Switzerland | 1 | 2% |
| Russia | 1 | 2% |
| Sweden | 1 | 2% |
| Other | 6 | 13% |
| Unknown | 15 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 28 | 62% |
| Practitioners (doctors, other healthcare professionals) | 14 | 31% |
| Scientists | 2 | 4% |
| Science communicators (journalists, bloggers, editors) | 1 | 2% |
Mendeley readers
The data shown below were compiled from readership statistics for 127 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Japan | 1 | <1% |
| Unknown | 126 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 26 | 20% |
| Researcher | 19 | 15% |
| Student > Master | 12 | 9% |
| Student > Ph. D. Student | 11 | 9% |
| Other | 9 | 7% |
| Other | 24 | 19% |
| Unknown | 26 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 85 | 67% |
| Engineering | 3 | 2% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Agricultural and Biological Sciences | 2 | 2% |
| Business, Management and Accounting | 1 | <1% |
| Other | 5 | 4% |
| Unknown | 29 | 23% |