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Radial artery pulse pressure variation correlates with brachial artery peak velocity variation in ventilated subjects when measured by internal medicine residents using hand-carried ultrasound devices.

Publication ,  Journal Article
Brennan, JM; Blair, JEA; Hampole, C; Goonewardena, S; Vasaiwala, S; Shah, D; Spencer, KT; Schmidt, GA
Published in: Chest
May 2007

BACKGROUND: Rapid prediction of the effect of volume expansion is crucial in unstable patients receiving mechanical ventilation. Both radial artery pulse pressure variation (DeltaPP) and change of aortic blood flow peak velocity are accurate predictors but may be impractical point-of-care tools. PURPOSES: We sought to determine whether respiratory changes in the brachial artery blood flow velocity (DeltaVpeak-BA) as measured by internal medicine residents using a hand-carried ultrasound (HCU) device could provide an accurate corollary to DeltaPP in patients receiving mechanical ventilation. METHODS: Thirty patients passively receiving volume-control ventilation with preexisting radial artery catheters were enrolled. The brachial artery Doppler signal was recorded and analyzed by blinded internal medicine residents using a HCU device. Simultaneous radial artery pulse wave and central venous pressure recordings (when available) were analyzed by a blinded critical care physician. RESULTS: A Doppler signal was obtained in all 30 subjects. The DeltaVpeak-BA correlated well with DeltaPP (r = 0.84) with excellent agreement (weighted kappa, 0.82) and limited intraobserver variability (2.8 +/- 2.8%) [mean +/- SD]. A DeltaVpeak-BA cutoff of 16% was highly predictive of DeltaPP > or = 13% (sensitivity, 91%; specificity, 95%). A poor correlation existed between the CVP and both DeltaVpeak-BA (r = - 0.21) and DeltaPP (r = - 0.16). CONCLUSIONS: The HCU Doppler assessment of the DeltaVpeak-BA as performed by internal medicine residents is a rapid, noninvasive bedside correlate to DeltaPP, and a DeltaVpeak-BA cutoff of 16% may prove useful as a point-of-care tool for the prediction of volume responsiveness in patients receiving mechanical ventilation.

Duke Scholars

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

May 2007

Volume

131

Issue

5

Start / End Page

1301 / 1307

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ultrasonography, Doppler
  • Stroke Volume
  • Respiratory System
  • Respiratory Mechanics
  • Respiration, Artificial
  • Regional Blood Flow
  • Radial Artery
  • Positive-Pressure Respiration
  • Point-of-Care Systems
 

Citation

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Brennan, J. M., Blair, J. E. A., Hampole, C., Goonewardena, S., Vasaiwala, S., Shah, D., … Schmidt, G. A. (2007). Radial artery pulse pressure variation correlates with brachial artery peak velocity variation in ventilated subjects when measured by internal medicine residents using hand-carried ultrasound devices. Chest, 131(5), 1301–1307. https://doi.org/10.1378/chest.06-1768
Brennan, J Matthew, John E. A. Blair, Chetan Hampole, Sascha Goonewardena, Samip Vasaiwala, Dipak Shah, Kirk T. Spencer, and Gregory A. Schmidt. “Radial artery pulse pressure variation correlates with brachial artery peak velocity variation in ventilated subjects when measured by internal medicine residents using hand-carried ultrasound devices.Chest 131, no. 5 (May 2007): 1301–7. https://doi.org/10.1378/chest.06-1768.
Journal cover image

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

May 2007

Volume

131

Issue

5

Start / End Page

1301 / 1307

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ultrasonography, Doppler
  • Stroke Volume
  • Respiratory System
  • Respiratory Mechanics
  • Respiration, Artificial
  • Regional Blood Flow
  • Radial Artery
  • Positive-Pressure Respiration
  • Point-of-Care Systems