Doppler Carotid Blood Flow to Predict Fluid Responsiveness with Passive Leg Raising in Shock – An Original Study

Background: Fluid therapy in intensive care units (ICU) is challenging as it requires identifying those who are fluid responsive using complex dynamic parameters of fluid responsiveness.Doppler carotid blood flow variation (CBFV) with passive leg raising (PLR) can be a quicker and easier technique.Materials and methods: This study evaluated CBFV with Doppler cardiac output and stroke volume variation (SVV) measured during PLR in patients with shock of varied etiology admitted to the ICU of a tertiary care center.Results: It was found that among the total of 35 patients, 17 patients were fluid responsive and 18 were nonresponsive.There was a strong correlation between cardiac output variation, SVV, and systolic carotid flow time variation with the PLR test.The calculated area under the receiver operating curve was 0.954 for cardiac output variation, 0.948 for SVV, and 0.902 for CBFV with the PLR test.A cut-off for CBFV of 8.5% resulted in a sensitivity of 82% and specificity of 83% to detect fluid responsiveness.Conclusion: Doppler CBFV with the PLR test can be used conveniently to identify fluid-responsive patients with shock admitted to the ICU.