Can carotid artery Doppler variations induced by the end-expiratory occlusion maneuver predict fluid responsiveness in septic shock patients?
Authors' conclusion
In septic shock patients without arrhythmias, an increase in CDPV greater than 10.5% during a 20-s EEOt predicted fluid responsiveness with > 95% specificity.
Study context
- Population
- Mechanically ventilated adults with septic shock without arrhythmias44 measurements
- Participants
- 18 participants
- Comparison
- Carotid Doppler changes during end-expiratory occlusion test (EEOt) vs CI changes for predicting fluid responsiveness
- Outcome
- Prediction of fluid responsiveness (CI increase ≥ 15% after 500 mL fluid challenge) by CDPV and cFT changes during a 20-s EEOt
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Performance
As reported in the abstract
Prediction of fluid responsiveness
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| CI | 0.85 | 78.9% | 91.7% |
| CD peak velocity (CDPV) | 0.74 | 53.0% | 96.2% |
AUC
CI0.85
CD peak velocity (CDPV)0.74
Sensitivity
CI78.9%
CD peak velocity (CDPV)53.0%
Specificity
CI91.7%
CD peak velocity (CDPV)96.2%
- CDPV measurements within the gray zone (from - 13.5 to 9.5 cm/s)
- 61%
Further findings
Correlation with CI changes during EEOt
- CDPV changes vs CI changes, r (0.26-0.71)
- 0.51
- Corrected flow time (cFT) changes vs CI changes, r (0.1-0.58)
- 0.35
Original publication
Can carotid artery Doppler variations induced by the end-expiratory occlusion maneuver predict fluid responsiveness in septic shock patients? Crit Care. Published 19 April 2023. doi:10.
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