Predicting Fluid Responsiveness Using Carotid Ultrasound in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis of Diagnostic Test
Prashant Nasa
ICU Physician - Co-editor: Rational use of IV Fluids in Critically ill (link in bio)- PROVE Network - Delphi Methodology - Fluid and Oxygen are Drugs - X: @drnasap
Published in Anesthesia and Analgesia
Summary:
This article is a systematic review and meta-analysis that evaluates the accuracy of carotid ultrasound as a tool to predict fluid responsiveness in mechanically ventilated patients. The study examines the potential of carotid ultrasound to help mitigate unnecessary fluid administration and assesses the diagnostic accuracy of various carotid ultrasound parameters.
??takeaways:
1. Change in carotid Doppler peak velocity (?CDPV) shows moderate accuracy in predicting fluid responsiveness in ventilated patients.
2. Existing literature supports the ability of carotid ultrasound to predict fluid responsiveness in mechanically ventilated adults, but study heterogeneity and undefined diagnostic cutoffs limit definitive conclusions.
3. Further high-quality studies with more homogenous designs are needed to further validate the technology.
Counter arguments:
1. Study heterogeneity, including a lack of clear parameter cutoffs, limited the generalizability of the results.
2. The overall quality of evidence was assessed as low, indicating potential limitations in the study methodology and data quality.