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Updated: Sep 29, 2025
09:32
Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
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Temporal concordance between pulse contour analysis, bioreactance and carotid doppler during rapid preload changes
Jon-Émile S Kenny1, Igor Barjaktarevic2, Andrew M Eibl1
1Health Sciences North Research Institute, Sudbury, ON, Canada.
Plos One
|March 23, 2022
Summary
Carotid Doppler ultrasound and non-invasive pulse contour accurately detected rapid hemodynamic changes. Bioreactance monitoring showed improved accuracy over time, highlighting the need to consider algorithm lag in clinical studies.
Area of Science:
- Cardiovascular Physiology
- Medical Monitoring Technology
Background:
- Hemodynamic monitoring is crucial for assessing cardiovascular function.
- Timely detection of hemodynamic changes is essential for effective clinical management.
- Evaluating the temporal concordance of different monitoring devices is important for understanding their real-world applicability.
Purpose of the Study:
- To compare the temporal accuracy of three different hemodynamic monitors.
- To assess the sensitivity and specificity of each monitor in detecting preload changes.
Main Methods:
- Healthy volunteers underwent controlled preload alterations.
- Simultaneous measurements were taken using a non-invasive pulse-contour stroke volume (SV) monitor, a bioreactance SV monitor, and a wireless Doppler ultrasound patch on the carotid artery.
- Data were analyzed across early, middle, and late temporal windows.
Main Results:
- Carotid Doppler ultrasound demonstrated high sensitivity (100%) and specificity (100%) immediately detecting preload changes (AUROC 0.98).
- Non-invasive pulse-contour monitoring showed comparable accuracy.
- Bioreactance monitoring had lower initial accuracy (60% sensitivity, 0.75 AUROC) but improved over time (70% sensitivity, 0.85 AUROC).
Conclusions:
- Carotid Doppler and non-invasive pulse-contour methods accurately detect rapid hemodynamic shifts.
- Bioreactance monitoring's accuracy improves with a slight delay.
- Algorithm lag in hemodynamic monitoring devices must be considered during clinical interpretation.
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