Kenny Jon-Émile Stuart, Clarke Geoffrey, Myers Matt, Elfarnawany Mai, Eibl Andrew M, Eibl Joseph K, Nalla Bhanu, Atoui Rony
Health Sciences North Research Institute, Sudbury, ON P3E 2H2, Canada.
Flosonics Medical, 325 Front Street, Toronto, ON M5V 2Y1, Canada.
Bioengineering (Basel). 2021 Dec 8;8(12):203. doi: 10.3390/bioengineering8120203.
A novel, wireless, ultrasound biosensor that adheres to the neck and measures real-time Doppler of the carotid artery may be a useful functional hemodynamic monitor. A unique experimental set-up during elective coronary artery bypass surgery is described as a means to compare the wearable Doppler to trans-esophageal echocardiography (TEE).
A total of two representative patients were studied at baseline and during Trendelenburg position. Carotid Doppler spectra from the wearable ultrasound and TEE were synchronously captured. Areas under the receiver operator curve (AUROC) were performed to assess the accuracy of changing common carotid artery velocity time integral (ccVTI) at detecting a clinically significant change in stroke volume (SV).
Synchronously measuring and comparing Doppler spectra from the wearable ultrasound and TEE is feasible during Trendelenburg positioning. In two representative cardiac surgical patients, the ccVTI accurately detected a clinically significant SV with AUROCs of 0.89, 0.91, and 0.95 when single-beat, 3-consecutive beat and 10-consecutive beat averages were assessed, respectively.
In this proof-of-principle research communication, a wearable Doppler ultrasound system is successfully compared to TEE. Preliminary data suggests that the diagnostic accuracy of carotid Doppler ultrasonography at detecting clinically significant SV is enhanced by averaging more cardiac cycles.
一种新型的、可穿戴的无线超声生物传感器，可附着于颈部并测量颈动脉的实时多普勒信号，可能是一种有用的功能性血流动力学监测器。本文描述了在择期冠状动脉搭桥手术期间的一种独特实验设置，作为比较可穿戴式多普勒与经食管超声心动图（TEE）的一种方法。
共对两名代表性患者在基线期和头低脚高位期间进行了研究。同步采集了可穿戴式超声和TEE的颈动脉多普勒频谱。进行受试者操作特征曲线下面积（AUROC）分析，以评估在检测每搏输出量（SV）的临床显著变化时，颈总动脉速度时间积分（ccVTI）变化的准确性。
在头低脚高位期间，同步测量和比较可穿戴式超声和TEE的多普勒频谱是可行的。在两名代表性心脏手术患者中，当分别评估单搏、连续3搏和连续10搏平均值时，ccVTI能准确检测到具有临床意义的SV，其AUROC分别为0.89、0.91和0.95。
在本原理验证性研究报告中，可穿戴式多普勒超声系统与TEE进行了成功比较。初步数据表明，通过对更多心动周期进行平均，颈动脉多普勒超声在检测具有临床意义的SV时的诊断准确性得到了提高。
