Da Luz Luis, Atwi Sarah, Notario Lowyl, Irvine Rachael, Farah Diane, Johnston Delaney, Kenny Jon-Emile S, Eibl Joseph K, Pannell Dylan
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Flosonics Medical, Greater Sudbury, Toronto, Ontario, Canada.
Transfusion. 2025 May;65 Suppl 1(Suppl 1):S123-S130. doi: 10.1111/trf.18241. Epub 2025 Apr 9.
Early detection of reduced stroke volume (SV) or cardiac output (CO) may expedite resuscitative interventions during traumatic hemorrhage; corrected carotid artery flow time (ccFT) has been proposed as a surrogate for SV during blood volume loss.
We conducted a prospective cohort study to assess the feasibility of using a wireless, wearable Doppler ultrasound capable of measuring ccFT in traumatically injured patients at a level 1 trauma center. A convenience sample of 33 patients was enrolled. We assessed device placement, data transfer and capture, and signal quality by assessing the ability to capture at least 15 consecutive cardiac cycles in the minute prior to blood pressure monitor cycling. A post hoc analysis examined ccFT variations between transfused and non-transfused patients.
Device placement succeeded in 94% of patients (n = 31) and the data were captured and transferred from all 31. The consecutive cardiac cycles before blood pressure measurement exceeded 15 (p = .015) in 93% of patients (n = 28). We observed ccFT below 270 ms and longer time spent under this threshold during resuscitation in transfused patients. Patients with low ccFT experienced more severe injuries and longer hospital and ICU stays.
This is the first study that demonstrates the feasibility of using a wearable Doppler ultrasound in trauma patients on admission to the trauma bay. Although findings suggest that ccFT could serve as an early marker of hemodynamic compromise, further large-scale, multicenter studies are needed to validate its predictive value and clinical utility in guiding trauma resuscitation.
早期发现每搏输出量（SV）或心输出量（CO）降低，可能会加快创伤性出血时的复苏干预；校正颈动脉血流时间（ccFT）已被提议作为失血期间SV的替代指标。
我们进行了一项前瞻性队列研究，以评估在一级创伤中心对创伤患者使用能够测量ccFT的无线可穿戴多普勒超声的可行性。纳入了33例患者的便利样本。我们通过评估在血压监测循环前一分钟内捕获至少15个连续心动周期的能力，来评估设备放置、数据传输和捕获以及信号质量。事后分析检查了输血患者和未输血患者之间的ccFT差异。
94%的患者（n = 31）设备放置成功，所有31例患者的数据均被捕获并传输。93%的患者（n = 28）在血压测量前的连续心动周期超过15个（p = 0.015）。我们观察到输血患者在复苏期间ccFT低于270毫秒，且在此阈值以下的时间更长。ccFT低的患者受伤更严重，住院和入住重症监护病房的时间更长。
这是第一项证明在创伤患者入院进入创伤室时使用可穿戴多普勒超声可行性的研究。尽管研究结果表明ccFT可作为血流动力学受损的早期标志物，但仍需要进一步的大规模、多中心研究来验证其在指导创伤复苏中的预测价值和临床实用性。
