• Joris van Houte, Frederik J Mooi, Leon J Montenij, Loek P B Meijs, Irene Suriani, Bente C M Conjaerts, Saskia Houterman, and Arthur R Bouwman.
• Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands; Department of Intensive Care, Catharina Hospital, Eindhoven, The Netherlands. Electronic address: joris.v.houte@catharinaziekenhuis.nl.
• J. Cardiothorac. Vasc. Anesth. 2022 Apr 1; 36 (4): 1081-1091.

ObjectiveCarotid Doppler ultrasound has been a topic of recent interest, as it may be a promising noninvasive hemodynamic monitoring tool. In this study, the relation between carotid artery blood flow and invasive cardiac output (CO) was evaluated.DesignA prospective, observational study.SettingA single-institution, tertiary referral hospital.ParticipantsEighteen elective cardiac surgery patients.InterventionsCO was measured by calibrated pulse contour analysis. Simultaneously, carotid artery pulsed-wave Doppler measurements were obtained in the operating room in three clinical settings: after induction of anesthesia (T1), after a passive leg raise maneuverer (T2), and at the end of surgery (T3).Measurements And Main ResultsCorrelation and trending between carotid artery blood flow and invasive CO were evaluated. Furthermore, two Bland-Altman plots were constructed to evaluate the level of agreement between carotid artery-derived CO and invasive CO measurements. Carotid artery blood flow correlated moderately with invasive CO (ρ = 0.67, 95% confidence interval 0.56-0.76, p < 0.05). Concordance between the percentage change of carotid artery blood flow and invasive CO from T1 to T3 was 72%. The level of agreement between carotid artery-derived CO and invasive CO was ±2.29; ±2.57 L/min, with a bias of 0.1; -0.54 L/min, and mean error of 50% and 48%, for the two Bland-Altman analyses, respectively. Intraexamination precision was acceptable.ConclusionsIn cardiac surgery patients, carotid artery blood flow correlated moderately with invasive CO measurements. However, the trending ability of carotid artery blood flow was poor, and carotid artery-derived CO tended not to be interchangeable with invasive CO.Copyright © 2021 Elsevier Inc. All rights reserved.

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