Resistive index measured at the anatomical snuffbox using Doppler ultrasound significantly correlated with systemic vascular resistance index (r=0.582, p<0.0001) in post-cardiac surgery patients.
Observational (n=15)
No
Does Doppler ultrasound measurement of resistive index at the anatomical snuffbox accurately correlate with systemic vascular resistance index in post-open-heart surgery ICU patients?
Doppler ultrasound measurement of the resistive index at the anatomical snuffbox provides a reliable, non-invasive indicator of systemic vascular resistance in post-cardiac surgery patients.
Effect estimate: r=0.582
p-value: p=<0.0001
BACKGROUND: To explore an alternative to the systemic vascular resistance index (SVRI) for monitoring peripheral circulation in patients in the intensive care unit (ICU), the resistive index (RI) in the upper extremity arteries was measured by using surface Doppler ultrasound. METHODS AND RESULTS: The correlation between RI and vascular resistance was assessed in vitro using a vessel phantom in a Donovan-type mock circulation system. In addition, 15 ICU patients who had undergone open-heart surgery were studied. Mean arterial pressure, central venous pressure and cardiac output were measured 30 times at 10 min intervals after patients returned to the ICU following surgery, and the SVRI was calculated from these parameters. At the same time points, 3 parts of the upper extremity arteries (brachial artery in the cubital fossa (BA), radial artery at the wrist (RA), and radial artery at the anatomical snuffbox (SB)) were scanned by Doppler ultrasound, and the resistance index (RI) for each artery region was calculated. In vitro, RI increased with higher vascular resistance, exhibiting a significant correlation (r = 0.982, p < 0.0001). In vivo, the average incidence angles at the BA and RA were larger than 60 degrees , while that at the SB was only 11.5+/-10.8 degrees. The overall correlation between SVRI and RI for all patients was not significant for the BA or RA, but was significant for the SB (p < 0.0001). In individual patients, the correlation of SVRI with RI at the BA or RA was significant in 3 patients only, whereas significant correlation for the SB was observed in all patients. Doppler waveform analysis at the SB revealed diastolic flow reversal with increased SVRI. CONCLUSIONS: Measurement at the SB provides an ideal ultrasound incidence angle for the measurement of blood flow velocity. Hence, RI measured in this way may serve as an indicator of peripheral vascular resistance, and may be effective for the evaluation of peripheral circulatory disturbance.
Ban et al. (Sat,) conducted a observational in Post-open-heart surgery ICU patients (n=15). Resistive index (RI) measurement at the anatomical snuffbox using Doppler ultrasound vs. Systemic vascular resistance index (SVRI) calculated from invasive measurements was evaluated on Correlation between SVRI and RI at the anatomical snuffbox (r=0.582, p=<0.0001). Resistive index measured at the anatomical snuffbox using Doppler ultrasound significantly correlated with systemic vascular resistance index (r=0.582, p<0.0001) in post-cardiac surgery patients.
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