Volume 23 Issue 3
Mar.  2025
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YU Zhe*, ZU Chenchen, SHENG Shizheng, LI Gang. Application of common carotid artery blood flow monitoring in fluid resuscitation of adult patients with septic shock[J]. Chinese Journal of General Practice, 2025, 23(3): 406-409. doi: 10.16766/j.cnki.issn.1674-4152.003914
Citation: YU Zhe*, ZU Chenchen, SHENG Shizheng, LI Gang. Application of common carotid artery blood flow monitoring in fluid resuscitation of adult patients with septic shock[J]. Chinese Journal of General Practice, 2025, 23(3): 406-409. doi: 10.16766/j.cnki.issn.1674-4152.003914
shu

Application of common carotid artery blood flow monitoring in fluid resuscitation of adult patients with septic shock

doi: 10.16766/j.cnki.issn.1674-4152.003914
  • 1.

    Department of Emergency Medicine, Chun' an Branch of Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 311700, China

Funds:

 2024ZL528

  • Received Date: 2024-02-10
    Available Online: 2025-05-14
    Abstract
  •   Objective  To monitor the velocity of common carotid artery in septic shock patients, and analyze the correlation between the variability of common carotid artery blood flow and the effect of fluid resuscitation.  Methods  A total of 107 patients with septic shock admitted to Chun ' an Branch of Zhejiang Provincial People ' s Hospital from August 2020 to June 2023 were taken as the research object. Before and after fluid resuscitation, they were divided into two groups according to the rising rate (ΔSVI) of cardiac stroke index (SVI). ΔSVI < 10% was non-response group (42 cases) and ΔSVI≥10% was response group (65 cases). The general data and ultrasonic parameters of the two groups were compared. Multivariate logistic regression was used to analyze the factors affecting the effect of liquid resuscitation. The value of ROC and AUC analysis of common carotid artery blood flow variability was used to evaluate the effect of fluid resuscitation.  Results  ΔASVI, velocity-time integral difference before and after passive leg raising test (ΔVTI), corrected blood flow time difference (ΔFTc), variation rate of common carotid artery peak flow velocity (ΔVpeakCA), respiratory variation rate of inferior vena cava (ΔIVC) and respiratory variation rate of aortic peak flow velocity (ΔVpeakAo) in the occurrence group were lower than those in the non-occurrence group, and the difference was statistically significant (P<0.05). Multivariate logistic regression results showed that ΔVTI (OR=1.087, 95% CI: 0.009-0.876), ΔFTc (OR=1.499, 95% CI: 1.013-2.219), ΔVpeakCA (OR=1.555, 95% CI: 1.071-2.256) and ΔIVC(OR=2.427, 95% CI: 1.060-5.554) were factors influencing the effectiveness of fluid resuscitation (P<0.05). ROC curve showed that the AUC of the combination of ΔVTI, ΔFTc, ΔVpeakCA and ΔIVC (0.969) was significantly higher than that of ΔVTI (0.833), ΔFTc (0.648), ΔVpeakCA (0.886) and ΔIVC (0.596).  Conclusion  The variability of common carotid artery blood flow is a factor affecting fluid resuscitation in patients with septic shock, and ΔVpeakCA has high evaluation value for patients.

     

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    • References(27)
  • [1]
    GAVELLI F, CASTELLO L M, AVANZI G C. Management of sepsis and septic shock in the emergency department[J]. Intern Emerg Med, 2021, 16(6): 1649-1661. doi: 10.1007/s11739-021-02735-7
    [2]
    EVANS L, RHODES A, ALHAZZANI W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021[J]. Intensive Care Med, 2021, 47(11): 1181-1247. doi: 10.1007/s00134-021-06506-y
    [3]
    BAKER J, KATTAN E, ANNANE D, et al. Current practice and evolving concepts in septic shock resuscitation[J]. Intensive Care Med, 2022, 48(2): 148-163. doi: 10.1007/s00134-021-06595-9
    [4]
    KATTAN E, OSPINA-TASCON G A, TEBOUL J L, et al. Systematic assessment of fluid responsiveness during early septic shock resuscitation: secondary analysis of the ANDROMEDA-SHOCK trial[J]. Crit Care, 2020, 24(1): 23. DOI: 10.1186/s13054-020-2732-y.
    [5]
    MARTIN G S, BASSETT P. Crystalloids vs. colloids for fluid resuscitation in the intensive care unit: a systematic review and meta-analysis[J]. J Crit Care, 2019, 50: 144-154. doi: 10.1016/j.jcrc.2018.11.031
    [6]
    王平, 李辉, 苑晓姣, 等. 基于下腔静脉相关指标及其变异性对脓毒症休克液体复苏效果预测价值分析[J]. 疑难病杂志, 2023, 22(5): 505-509. doi: 10.3969/j.issn.1671-6450.2023.05.012

    WANG P, LI H, YUAN X J, et al. Analysis of the predictive value of inferior vena cava related indicators and their variability for fluid resuscitation in septic shock[J]. Chinese Journal of Difficult and Complicated Cases, 2023, 22(5): 505-509. doi: 10.3969/j.issn.1671-6450.2023.05.012
    [7]
    李尧炜, 李晓峰, 梁彦平, 等. 下腔静脉呼吸变异指数、血清脑钠肽水平对脓毒症休克患者容量反应性的预测效能[J]. 山东医药, 2020, 60(15): 81-84.

    LI Y W, LI X F, LIANG Y P, et al. Predictive efficacy of inferior vena cava respiratory variability index and serum brain natriuretic peptide level on volume responsiveness of septic shock patients[J]. Shandong Medical Journal, 2020, 60(15): 81-84.
    [8]
    罗美倩, 于洋, 胡迎春, 等. 脓毒症患者预后相关关键基因的生物信息学分析[J]. 四川医学, 2021, 42(9): 865-870.

    LUO M Q, YU Y, HU Y C, et al. Bioinformatics analysis of key genes associated with prognosis in patients with sepsis[J]. Sichuan Medical Journal, 2021, 42(9): 865-870.
    [9]
    KATTAN E, BKKER J, ESTENSSORO E, et al. Hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock: the ANDROMEDA-SHOCK-2 Randomized Clinical Trial study protocol[J]. Rev Bras Ter Intensiva, 2022, 34(1): 96-106.
    [10]
    中华医学会急诊医学分会, 中国医师协会急诊医师分会, 中国人民解放军急救医学专业委员会, 等. 脓毒症液体治疗急诊专家共识[J]. 中华急诊医学杂志, 2018, 27(1): 30-38.

    Emergency Medicine Branch of Chinese Medical Association, Emergency Physician Branch of Chinese Medical Association, Emergency Medicine Committee of China People ' s Liberation Army, et al. Expert Consensus on Emergency Treatment of Sepsis with Liquid[J]. Chinese Journal of Emergency Medicine, 2018, 27(1): 30-38.
    [11]
    KUTTAB H I, LYKINS J D, HUGHES M D, et al. Evaluation and predictors of fluid resuscitation in patients with severe sepsis and septic shock[J]. Crit Care Med, 2019, 47(11): 1582-1590. doi: 10.1097/CCM.0000000000003960
    [12]
    BURGUNDER L, HEYREND C, OLSIN J, et al. Medication and fluid management of pediatric sepsis and septic shock[J]. Paediatr Drugs, 2022, 24(3): 193-205. doi: 10.1007/s40272-022-00497-z
    [13]
    范昊, 邵韩, 臧宝赫. 细胞因子联合急性生理学与慢性健康状况评分Ⅱ及多器官功能障碍综合征评分对脓毒症患者短期预后的评价[J]. 中国临床医生杂志, 2023, 51(4): 496-499. doi: 10.3969/j.issn.2095-8552.2023.04.035

    FAN H, SHAO H, ZANG B H. Evaluation of short-term prognosis of sepsis patients by cytokine combined with acute physiology and chronic health status score Ⅱ and multiple organ dysfunction syndrome score[J]. Chinese Journal For Clinicians, 2023, 51(4): 496-499. doi: 10.3969/j.issn.2095-8552.2023.04.035
    [14]
    刘炳炜, 徐燕平, 席绍松, 等. SOFA评分联合PCT检测对脓毒症患者病情及其预后的临床评估价值[J]. 中华全科医学, 2021, 19(3): 391-393. doi: 10.16766/j.cnki.issn.1674-4152.001818

    LIU B W, XU Y P, XI S S, et al. Clinical value of SOFA combined with procalcitonin test in assessing the condition and prognosis of patients with sepsis[J]. Chinese Journal of General Practice, 2021, 19(3): 391-393. doi: 10.16766/j.cnki.issn.1674-4152.001818
    [15]
    ABDALAZIZ F A, ALGEBALY H A F, ISMIL R I, et al. The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock[J]. Rev Bras Ter Intensiva, 2018, 30(4): 460-470. http://www.rbti.org.br/exportar-pdf/0103-507X-rbti-30-04-0460-en.pdf
    [16]
    马朝阳. 液体容量负荷与严重脓毒症急性肾损伤患者预后的相关性[J]. 医药论坛杂志, 2021, 42(8): 76-78, 82.

    MA C Y. Correlation between fluid volume load and prognosis of patients with severe sepsis and acute kidney injury[J]. Journal of Medical Forum, 2021, 42(8): 76-78, 82.
    [17]
    LABIB A. Sepsis care pathway 2019[J]. Qatar Med J, 2019, 2019(2): 4. DOI: 10.5339/qmj.2019.qccc.4.
    [18]
    DARRIGO S, DELLANNA A M, SANDEONI C, et al. Can carotid artery Doppler variations induced by the end-expiratory occlusion maneuver predict fluid responsiveness in septic shock patients?[J]. Crit Care, 2023, 27(1): 153. DOI: 10.1186/s13054-023-04422-9.
    [19]
    DE BACKER D, CECCONI M, LIPMAN J, et al. Challenges in the management of septic shock: a narrative review[J]. Intensive Care Med, 2019, 45(4): 420-433. doi: 10.1007/s00134-019-05544-x
    [20]
    SIDOR M, PREMACHANDRA L, HANNA B, et al. Carotid flow as a surrogate for cardiac output measurement in hemodynamically stable participants[J]. J Intensive Care Med, 2020, 35(7): 650-655. http://d.wanfangdata.com.cn/periodical/00b2b440c9b7575ff79953ed1dae2546
    [21]
    KENNY J S, BARJAKTAREVIC I, EIBL A M, et al. A wearable carotid Doppler tracks changes in the descending aorta and stroke volume induced by end-inspiratory and end-expiratory occlusion: a pilot study[J]. Health Sci Rep, 2020, 3(4): e190. DOI: 10.1002/hsr2.190.
    [22]
    ANTAL O, ȘTEFANESCU E, MLESNITE M, et al. Hemodynamic predictors for sepsis-induced acute kidney injury: a preliminary study[J]. J Clin Med, 2020, 9(1): 151. DOI: 10.3390/jcm9010151.
    [23]
    STURGESS D J, PASCOE R L, SCALIA G, et al. A comparison of transcutaneous Doppler corrected flow time, B-type natriuretic peptide and central venous pressure as predictors of fluid responsiveness in septic shock: a preliminary evaluation[J]. Anaesth Intensive Care, 2010, 38(2): 336-341. http://pubmed.ncbi.nlm.nih.gov/20369768/
    [24]
    PATEL A K, MISTRY K, BRESLIN K, et al. Carotid Artery flow time measured by point-of-care ultrasound correlates with volume changes in pediatric hemodialysis patients[J]. Ultrasound Med Biol, 2020, 46(7): 1670-1676. http://www.sciencedirect.com/science/article/pii/S0301562920301502
    [25]
    BUGHRRARA N, DOAZ-GOMEZ J L, PUSTAVOITAU A. Perioperative management of patients with sepsis and septic shock, part Ⅱ: ultrasound support for resuscitation[J]. Anesthesiol Clin, 2020, 38(1): 123-134.
    [26]
    WEISS S L, PETERS M J, ALHAZZANI W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children[J]. Pediatr Crit Care Med, 2020, 21(2): e52-e106. http://doc.paperpass.com/foreign/rgArti20206778581.html
    [27]
    徐欣欣, 白静, 冯凯, 等. 脉搏灌注指数监测评估脓毒症及脓毒性休克患者血流动力学的研究进展[J]. 中华急诊医学杂志, 2022, 31(11): 1571-1574.

    XU X X, BAI J, FENG K, et al. Research progress of monitoring and evaluating hemodynamics in patients with sepsis and septic shock by pulse perfusion index[J]. Chinese Journal of Emergency Medicine, 2022, 31(11): 1571-1574.
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