Correlation and concordance of carotid Doppler ultrasound and echocardiography with invasive cardiac output measurement in critically ill patients

• Published in: Intensive care medicine experimental Vol. 12; no. 1; pp. 69 - 8
• Main Authors: Arango-Granados, María Camila, Quintero-Ramírez, Jaime Andrés, Mejía-Herrera, Felipe, Henao-Cardona, Lina Mayerly, Muñoz-Patiño, Valentina, Bustamante-Cristancho, Luis Alfonso
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 12.08.2024; Springer Nature B.V; SpringerOpen
• Subjects: Accuracy; Acoustics; Cardiac arrhythmia; Cardiac output; Carotid arteries; Carotid Doppler; Critical care; Critical Care Medicine; Doppler effect; Echocardiography; Emergency medical care; Flow velocity; Heart failure; Hemodynamics; Intensive; Intensive care; Invasive hemodynamic monitoring; Measurement techniques; Medicine; Medicine & Public Health; Mortality; Patients; Pulmonary arteries; Reproducibility; Ultrasonic imaging; Ultrasound; Veins & arteries; Invasive hemodynamic monitoring; Intensive care; Echocardiography; Cardiac output; Carotid Doppler; Ultrasound
• ISSN: 2197-425X; 2197-425X
• DOI: 10.1186/s40635-024-00653-4

Background Critical care management heavily relies on accurate cardiac output (CO) measurement. Echocardiography has been a mainstay in non-invasive cardiac monitoring; however, its comparability to invasive methods warrants further exploration. Recent studies have suggested the potential of carotid Doppler measurements as a promising approach to estimate CO. Despite this potential, the literature presents mixed outcomes regarding its reliability and accuracy. This study aims to evaluate the correlation and concordance between carotid Doppler ultrasonography and invasive hemodynamic monitoring in estimating CO in critically ill patients. Furthermore, it assesses the concordance and correlation between echocardiography CO and the standard invasive CO measurements. Methods This concordance study involved critically ill adults requiring invasive CO measurement. Patients with arrhythmias, severe valvulopathy, pregnancy, and poor acoustic window were excluded. Statistical analyses comprised univariate analysis, Wilcoxon signed-rank test, Spearman correlation, and intraclass correlation coefficient. Ethical approval was granted by the institution’s ethics committee. Results A total of 49 critically ill patients were included, predominantly male (63.27%), with a median age of 57 years. Diagnoses included subarachnoid hemorrhage (53.06%) and heart failure (8.16%). Mean cardiac index was 3.36 ± 0.81 L/min/m 2 and mean cardiac output was 5.98 ± 1.47 L/min. Spearman correlation coefficient between echocardiography and invasive CO measurements was 0.58 ( p -value =  p  < 0.001), with an ICC of 0.59 for CO and 0.52 for cardiac index. Carotid measurements displayed no significant correlation with invasive CO. Conclusion There is a moderate correlation and concordance between echocardiography and invasive CO measurements. There is no significant correlation between carotid variables and invasive CO, underscoring the necessity for cautious interpretation and application, particularly in patients with distinctive cerebral blood flow dynamics.