Feasibility of bedside ultrasound monitoring the periodic variation rate of peak velocity of common carotid artery with positive pressure ventilation in the evaluation of the volume status of surgical ICU patients

ObjectiveTo investigate the effects and feasibility of bedside ultrasound monitoring the periodic variation rate of peak velocity of common carotid artery with positive pressure ventilation in evaluating the volume status of surgical ICU patients.

MethodsThe capacity load in 50 surgical ICU patients treated with mechanical ventilation was tested.According to the added value of stroke volume(ΔSV)of the gold standard for assessing volumetric reactivity, the patients were divided into the reaction group(28 cases, rehydration capacity, ΔSV ≥15%)and non-reaction group(22 cases, rehydration capacity without reaction, ΔSV < 15%).All patients were monitored using bedside ultrasound, the periodic variation rate of peak velocity of common carotid artery(ΔVpeak-CCA)was compared between two groups, and the correlation between ΔVpeak-CCA and ΔSV was analyzed.

ResultsThere was no statistical significance in SV between two groups before and after the expansion(P>0.05), the ΔSV and ΔVpeak-CCA in reaction group were significantly higher than those in non-reaction group(P < 0.05), and the Vpeak-max and Vpeak-min in reaction group were lower than those in non-reaction group(P < 0.05).The ΔSV of surgical ICU patients was positively correlated with the ΔVpeak-CCA(r=0.862, P < 0.05).The area under the ΔVpeak-CCA ROC curve was 0.846, the diagnostic threshold of ΔVpeak-CCA was 12.36%, the sensitivity was 93.48%, and the specificity was 81.09%.

ConclusionsThe bedside ultrasound monitoring the periodic variation rate of peak velocity of common carotid artery with positive pressure ventilation in evaluating the volume status of surgical ICU patients is effective and feasible.It can provide a basis for physicians to analyze the patients' condition, and is worthy of popularization.