Key result
Corrected blood flow time (FTc) via carotid ultrasound accurately predicted perioperative hypotension (sensitivity 0.82, specificity 0.94, AUC 0.95) and fluid responsiveness.
Why the study?
The efficacy of carotid ultrasound for predicting hypotension and fluid responsiveness remains unclear in the perioperative setting.
Does carotid ultrasound using FTc and ΔVpeak predict perioperative hypotension and fluid responsiveness in patients in the perioperative setting?
Meta-Analysis
Does carotid ultrasound using FTc and ΔVpeak predict perioperative hypotension and fluid responsiveness in patients in the perioperative setting?
Effect estimate: pooled sensitivity 0.82 (95% CI 0.72 to 0.89)
Carotid ultrasound using corrected blood flow time (FTc) demonstrates high diagnostic accuracy for predicting perioperative hypotension and fluid responsiveness.
FTc supports perioperative hypotension risk stratification; reinforces carotid ultrasound for fluid responsiveness assessment.
Despite the acceptance of carotid ultrasound for predicting patients' fluid responsiveness in critical care and anesthesia, its efficacy for predicting hypotension and fluid responsiveness remains unclear in the perioperative setting. Electronic databases were searched from inception to May 2023 to identify observational studies focusing on the use of corrected blood flow time (FTc) and respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak) for assessing the risks of hypotension and fluid responsiveness. Using FTc as a predictive tool (four studies), the analysis yielded a pooled sensitivity of 0.82 (95% confidence interval (CI): 0.72 to 0.89) and specificity of 0.94 (95% CI: 0.88 to 0.97) for the risk of hypotension (area under curve (AUC): 0.95). For fluid responsiveness, the sensitivity and specificity of FTc were 0.79 (95% CI: 0.72 to 0.84) and 0.81 (95% CI: 0.75 to 0.86), respectively (AUC: 0.87). In contrast, the use of ΔVpeak to predict the risk of fluid responsiveness showed a pooled sensitivity of 0.76 (95% CI: 0.63 to 0.85) and specificity of 0.74 (95% CI: 0.66 to 0.8) (AUC: 0.79). The current meta-analysis provides robust evidence supporting the high diagnostic accuracy of FTc in predicting perioperative hypotension and fluid responsiveness, which requires further studies for verification.
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Hung et al. (2023) conducted a meta-analysis in Perioperative hypotension and fluid responsiveness. Carotid ultrasound (FTc and ΔVpeak) was evaluated on Risk of perioperative hypotension using corrected blood flow time (FTc) (pooled sensitivity 0.82, 95% CI 0.72 to 0.89). Corrected blood flow time (FTc) via carotid ultrasound accurately predicted perioperative hypotension (sensitivity 0.82, specificity 0.94, AUC 0.95) and fluid responsiveness.
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