Division of Pediatric Emergency Medicine and Trauma Services, Children's National Health System, George Washington University, School of Medicine and Health Sciences, Washington, DC, USA.
Division of Pediatric Nephrology, Children's National Health System, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Ultrasound Med Biol. 2020 Jul;46(7):1670-1676. doi: 10.1016/j.ultrasmedbio.2020.03.034. Epub 2020 May 6.
Carotid artery flow time corrected for heart rate (CFTc) correlates with intravascular volume changes in adults but has not been studied adequately in the pediatric population. We studied how fluid status changes correlate with CFTc in pediatric patients undergoing hemodialysis. This prospective observational study involved pediatric patients aged 5-18 y undergoing chronic hemodialysis at a tertiary care children's hospital in the United States. We measured CFTc by point-of-care ultrasound before and after each hemodialysis session, including passive leg raise. One hundred sixty-eight CFTc measurements were obtained from a total of 21 patient encounters. Post-dialysis CFTc decreased by 21.7 ms (95% confidence interval: 12.3-31.0) (p < 0.001). Pre- and post-dialysis ∆CFTc measurements were proportionally correlated with volume removed in dialysis adjusted for weight (mL/kg) (R = 0.224, p = 0.03). There was no significant change in mean CFTc with passive leg raise before or after hemodialysis. In children on hemodialysis, changes in CFTc were moderately correlated with decrease in intravascular volume after hemodialysis.
颈总动脉血流时间校正心率（CFTc）与成人的血管内容量变化相关，但在儿科人群中尚未得到充分研究。我们研究了在接受血液透析的儿科患者中，液体状态变化与 CFTc 的相关性。这项前瞻性观察研究涉及美国一家三级儿童保健医院接受慢性血液透析的 5-18 岁儿科患者。我们在每次血液透析前后（包括被动抬腿）通过即时超声测量 CFTc。总共从 21 次患者就诊中获得了 168 次 CFTc 测量值。透析后 CFTc 下降了 21.7ms（95%置信区间：12.3-31.0）（p<0.001）。调整体重后，透析去除的体积（mL/kg）与透析前后 ∆CFTc 测量值呈比例相关（R=0.224，p=0.03）。在血液透析前后，被动抬腿时 CFTc 的平均值没有明显变化。在接受血液透析的儿童中，CFTc 的变化与血液透析后血管内容量的减少中度相关。
