• Ann Emerg Med · Sep 2015

    Observational Study

    Carotid Flow Time Changes With Volume Status in Acute Blood Loss.

    • David C Mackenzie, Noman A Khan, David Blehar, Scott Glazier, Yuchiao Chang, Christopher P Stowell, Vicki E Noble, and Andrew S Liteplo.
    • Department of Emergency Medicine, Maine Medical Center, Portland, ME, and Tufts University School of Medicine, Boston, MA. Electronic address: DMackenzie@mmc.org.
    • Ann Emerg Med. 2015 Sep 1; 66 (3): 277-282.e1.

    Study ObjectiveNoninvasive predictors of volume responsiveness may improve patient care in the emergency department. Doppler measurements of arterial blood flow have been proposed as a predictor of volume responsiveness. We seek to determine the effect of acute blood loss and a passive leg raise maneuver on corrected carotid artery flow time.MethodsIn a prospective cohort of blood donors, we obtained a Doppler tracing of blood flow through the carotid artery before and after blood loss. Measurements of carotid flow time, cardiac cycle time, and peak blood velocity were obtained in supine position and after a passive leg raise. Measurements of flow time were corrected for pulse rate.ResultsSeventy-nine donors were screened for participation; 70 completed the study. Donors had a mean blood loss of 452 mL. Mean corrected carotid artery flow time before blood loss was 320 ms (95% confidence interval [CI] 315 to 325 ms); this decreased after blood loss to 299 ms (95% CI 294 to 304 ms). A passive leg raise had little effect on mean corrected carotid artery flow time before blood loss (mean increase 4 ms; 95% CI -1 to 9 ms), but increased mean corrected carotid artery flow time after blood loss (mean increase 23 ms; 95% CI 18 to 28 ms) to predonation levels.ConclusionCorrected carotid artery flow time decreased after acute blood loss. In the setting of acute hypovolemia, a passive leg raise restored corrected carotid artery flow time to predonation levels. Further investigation of corrected carotid artery flow time as a predictor of volume responsiveness is warranted.Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…