Fluctuation in and Correlation Between Carotid Blood Flow Velocity and Systemic Hemodynamics During Pulmonary Surgery

Abstract

Background: Carotid ultrasonography can be used as a minimally invasive method of evaluating systemic hemodynamics. We investigated carotid artery flow velocity during one-lung ventilation (OLV) to test our hypothesis that the measured values from carotid ultrasonography would positively correlate with global hemodynamic values, blood pressure, and arterial pressure-based cardiac output (APCO).
Methods: The study group comprised 43 consecutive patients who underwent pulmonary surgery between April and September 2017. Common carotid artery measurements on the same side as the non-dependent lung were obtained at 8 time points: before induction of general anesthesia, after tracheal intubation, after positional change, at 15, 30, 60, and 90 minutes after initiation of OLV, and 15 minutes after OLV. We measured peak systolic velocity (PSV) of the common carotid artery. Non-invasive systolic blood pressure (NISBP), non-invasive mean blood pressure (NIMBP), non-invasive diastolic blood pressure (NIDBP), systolic arterial pressure (SAP), mean arterial pressure (MAP), and diastolic arterial pressure (DAP), and APCO were recorded at the same points.
Results: PSV increased significantly after a change to the lateral decubitus position. Multiple regression analysis showed PSV was affected by APCO, SAP, age, and history of hypertension (R² = 0.23). APCO was the most affective factor (β = 8.35, SE = 1.60, t = 5.22, P < 0.0001). The second was SAP (β = ‒0.37, SE = 0.08, t = ‒4.75, P < 0.0001).
Conclusions: Carotid ultrasonography may be useful for evaluating systemic hemodynamics during pulmonary surgery.