Corrected carotid flow time and passive leg raise as a measure of volume status

Abstract

Background: The aim of this study was to investigate the value of corrected carotid flow time (FTc) with passive leg raise (PLR) as a non-invasive marker of volume status in end stage renal disease (ESRD) patients. Methods: Prospective observational study of ESRD patients presenting to the Emergency department requiring hemodialysis. The common carotid artery was evaluated in long axis. Flow time measurements pre- and post-dialysis as well as before and after PLR were recorded. Results: 54 patients were enrolled, of which, 30 (55%) were male. The mean age was 47.4 years. The mean volume of fluid removed was 3.89 ± 0.91 L. In the pre-dialysis cohort, the mean FTc was 340.16 ms (95% CI, 330.36–349.95). Following PLR, the mean FTc was 341.34 ms (95% CI 331.74–350.94). In the post hemodialysis cohort, the mean FTc was 302.48 ms (95% CI, 293.63–311.32). Following the PLR maneuver, the mean FTc was 340.49 ms (95% CI 331.97–349.02). The mean decrease in corrected carotid flow time was 19.15 ms (95% CI, 22.86–41.17), 32.02 ms (95% CI 4.05–34.25) and 41.17 ms (95% CI, 36.47–54.76) for patients who had <3 L, 3-4 L and >4 L removed, respectively. In patients without CHF, the mean decrease in FTc after hemodialysis was 38.80 ms (95% CI, 30.12–47.49) whereas for CHF patients the mean decrease was 35.60 ms (95% CI, 25.05–46.15). Conclusion: Corrected flow time in conjunction with passive leg raise seem to correlate with volume status in hemodialysis patients. © 2018 Elsevier Inc.