Common Carotid Artery Sonography Versus Transthoracic Echocardiography for Cardiac Output Measurements in Intensive Care Unit Patients

J Ultrasound Med. 2017 Sep;36(9):1793-1799. doi: 10.1002/jum.14214. Epub 2017 Apr 21.

Abstract

Objectives: This study was designed to test the effectiveness of common carotid artery sonography in comparison with transthoracic echocardiography (TTE) for cardiac output measurements to provide an easier alternative for cardiac output monitoring in the intensive care unit.

Methods: This study included 148 patients who had common carotid artery Doppler examinations and TTE performed within 8 hours of each other, and the cardiac output measurement results were compared with each other.

Results: The mean age of the participants ± SD was 56.8 ± 16.2 years, with male patients composing 54.7% of the cohort. There was no significant difference in carotid and TTE cardiac output between different sexes, age groups, patients with and without mechanical ventilation, and primary indication groups. The overall intraclass correlation coefficient between the carotid and TTE cardiac output was 0.537. In patients with septic shock, multiple trauma, and respiratory failure, the intraclass correlation coefficients between TTE and carotid cardiac output were 0.241, 0.061, and 0.095, respectively.

Conclusions: Carotid cardiac output shows moderate agreement with TTE cardiac output; thus, its use may be considered as an alternative for estimating cardiac output in emergencies and when TTE cardiac output is unobtainable. However, in patients with septic shock, multiple trauma, and respiratory failure, the use of carotid cardiac output is not recommended.

Keywords: cardiac output; common carotid artery; intensive care; sonography; transthoracic echocardiography.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cardiac Output / physiology*
  • Carotid Artery, Common / diagnostic imaging*
  • Carotid Artery, Common / physiopathology*
  • Critical Care / methods*
  • Echocardiography / methods*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ultrasonography, Doppler / methods*