Department of Anesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Hyderabad, Telangana, India.
Korean J Anesthesiol. 2023 Jun;76(3):183-193. doi: 10.4097/kja.22385. Epub 2022 Nov 15.
Dynamic parameters used for predicting fluid responsiveness require special equipment and are minimally invasive. Therefore, recent interest in the use of carotid artery ultrasound parameters, such as carotid corrected flow time (FTc) and peak velocity variation (ΔVpeak) has grown. Therefore, we performed this systematic review and meta-analysis to assess the ability of carotid FTc and/or ΔVpeak to accurately predict fluid responsiveness.
We searched the PubMed and Embase databases for articles evaluating the diagnostic accuracy of carotid FTc or ΔVpeak for predicting fluid responsiveness. Two independent authors performed the search and selected studies published until May 2022. The studies were assessed for the inclusion and exclusion criteria using Rayyan (Rayyan Systems Inc., 2022).
Ten studies (n=438) that fulfilled the inclusion criteria were selected. Studies were divided into those assessing carotid FTc and those assessing carotid ΔVpeak. Five studies (six datasets) assessed FTc. The pooled sensitivity and specificity of carotid FTc were 0.76 and 0.88, respectively. The summary receiver operating characteristic (SROC) curve for carotid FTc had an area under the curve (AUC) of 0.9092, with a Q value of 0.8412. Seven studies calculated carotid ΔVpeak. The pooled sensitivity and specificity for ΔVpeak were 0.83 and 0.81, respectively. The SROC curve had an AUC of 0.8941 and a Q value of 0.8250.
Our meta-analysis showed that both carotid FTc and ΔVpeak are useful for predicting fluid responsiveness in anesthesia and critical care settings with good specificity and sensitivity.
用于预测液体反应性的动态参数需要特殊设备且具有微创性。因此，最近人们对颈动脉超声参数（如颈动脉校正流量时间（FTc）和峰值速度变化（ΔVpeak））的应用产生了兴趣。因此，我们进行了这项系统评价和荟萃分析，以评估颈动脉 FTc 和/或 ΔVpeak 准确预测液体反应性的能力。
我们在 PubMed 和 Embase 数据库中搜索评估颈动脉 FTc 或 ΔVpeak 预测液体反应性的诊断准确性的文章。两名独立的作者进行了搜索，并选择了截至 2022 年 5 月发表的研究。使用 Rayyan（Rayyan Systems Inc.，2022 年）评估研究是否符合纳入和排除标准。
选择了符合纳入标准的 10 项研究（n=438）。这些研究分为评估颈动脉 FTc 和评估颈动脉 ΔVpeak 的研究。五项研究（六个数据集）评估了 FTc。颈动脉 FTc 的汇总敏感性和特异性分别为 0.76 和 0.88。颈动脉 FTc 的汇总受试者工作特征（SROC）曲线下面积（AUC）为 0.9092，Q 值为 0.8412。七项研究计算了颈动脉 ΔVpeak。ΔVpeak 的汇总敏感性和特异性分别为 0.83 和 0.81。SROC 曲线的 AUC 为 0.8941，Q 值为 0.8250。
我们的荟萃分析表明，颈动脉 FTc 和 ΔVpeak 均可用于预测麻醉和重症监护环境中的液体反应性，具有良好的特异性和敏感性。
