The hands-free continuous carotid Doppler patch monitoring of carotid minute distance tracked directional changes in cardiac output with a 98.5% concordance rate and R2 of 0.58 compared to invasive thermodilution in 41 cardiac surgery patients.
Prospective (n=41)
No
Does carotid minute distance measured by a continuous carotid Doppler patch accurately track directional changes in cardiac output compared to thermodilution in mechanically ventilated cardiac surgery patients?
A hands-free continuous carotid Doppler patch can reliably track directional changes in cardiac output in mechanically ventilated cardiac surgery patients, offering a non-invasive alternative for hemodynamic trending.
Effect estimate: Concordance rate 98.5% between percentage change in CO and cMD; coefficient of determination R2=0.58 (p<0.001)
p-value: p=<0.001
Hands-free patch for continuous quantitative monitoring of common carotid artery (CCA) blood flow has gained interest in recent years. The aim of this study was to evaluate whether carotid minute distance (cMD), collected from a hands-free continuous wave Doppler, allows tracking directional changes incardiac output (CO) induced by passive leg raising (PLR) or dobutamine test in cardiac surgery patients. Cardiac surgery patients with pulmonary artery catheter or transpulmonary thermodilution monitoring were enrolled. Four-quadrant plot was adopted to evaluate the concordance between the percentage change of CCA cMD, which was the product of heart rate and velocity time integral, and invasive CO induced by PLR or dobutamine test. A total of 41 cardiac surgery patients were enrolled and 82 pairs of invasive CO and cMD induced by the PLR or dobutamine test were collected in this study. Following the PLR test, significant increases were observed in CO (5.3 ± 1.1 vs. 5.7 ± 1.3 L/min, p﹤0.001). Similarly, dobutamine administration resulted in marked elevations of CO (5.3 ± 1.1 vs. 6.0 ± 1.3 L/min, p﹤0.001). Compared with baseline values, cMD demonstrated significant enhancement following both PLR test and dobutamine challenge. The concordance rate between percentage change of CO and cMD was 98.5%, with the coefficient of determination (R2) be 0.58 (p﹤0.001). In cardiac surgery patients, cMD collected from a hands-free CADFlow monitor system could reliably tracking directional changes of CO, with thermodilution technique be the reference method. Trial registration: ClinicalTrials.gov (NCT05944146). Registered July 12, 2023.
Hao et al. (Tue,) conducted a prospective in Cardiac surgery patients under mechanical ventilation (n=41). Hands-free continuous carotid Doppler patch monitoring of carotid minute distance (cMD) vs. Invasive cardiac output measurement by thermodilution technique was evaluated on Directional changes in cardiac output (CO) measured by thermodilution compared to changes in carotid minute distance (cMD) measured by continuous Doppler patch (Concordance rate 98.5% between percentage change in CO and cMD; coefficient of determination R2=0.58 (p<0.001), p=<0.001). The hands-free continuous carotid Doppler patch monitoring of carotid minute distance tracked directional changes in cardiac output with a 98.5% concordance rate and R2 of 0.58 compared to invasive thermodilution in 41 cardiac surgery patients.