A Carotid Doppler Patch Accurately Tracks Stroke Volume Changes During a Preload-Modifying Maneuver in Healthy Volunteers

Abstract

Objectives: Detecting instantaneous stroke volume change in response to altered cardiac preload is the physiologic foundation for determining preload responsiveness. Design: Proof-of-concept physiology study. Setting: Research simulation laboratory. Subjects: Twelve healthy volunteers. Interventions: A wireless continuous wave Doppler ultrasound patch was used to measure carotid velocity time integral and carotid corrected flow time during a squat maneuver. The Doppler patch measurements were compared with simultaneous stroke volume measurements obtained from a noninvasive cardiac output monitor. Measurements and Main Results: From stand to squat, stroke volume increased by 24% while carotid velocity time integral and carotid corrected flow time increased by 32% and 9%, respectively. From squat to stand, stroke volume decreased by 13%, while carotid velocity time integral and carotid corrected flow time decreased by 24% and 10%, respectively. Both changes in carotid velocity time integral and corrected flow time were closely correlated with changes in stroke volume ( r 2 = 0.81 and 0.62, respectively). The four-quadrant plot found a 100% concordance rate between changes in stroke volume and both changes in carotid velocity time integral and changes in corrected flow time. A change in carotid velocity time integral greater than 15% predicted a change in stroke volume greater than 10% with a sensitivity of 95% and a specificity of 92%. A change in carotid corrected flow time greater than 4% predicted a change in stroke volume greater than 10% with a sensitivity of 90% and a specificity of 92%. Conclusions: In healthy volunteers, both carotid velocity time integral and carotid corrected flow time measured by a wireless Doppler patch were useful to track changes in stroke volume induced by a preload-modifying maneuver with high sensitivity and specificity.

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