Diagnostic Performance of Corrected Carotid Flow Time for Assessing Fluid Responsiveness in Patients With Septic or Hypovolemic Shock: A Prospective Diagnostic Accuracy Study
Year: 2026
Type: article
Abstract: Background Predicting fluid responsiveness in patients with hemodynamic instability remains challenging. Corrected carotid flow time (CFTc) is a non-invasive bedside Doppler measure proposed to identify fluid responsiveness, but its reported performance is inconsistent. We evaluated baseline CFTc as a predictor of fluid responsiveness and assessed whether the post-bolus percentage change in CFTc corresponded with the echocardiographic change in stroke volume. Materials and methods This prospective diagnostic accuracy study included 80 adult patients presenting with new-onset shock of presumed septic and/or hypovolemic origin. All received a clinically indicated first bolus of 10 mL/kg Ringer's lactate. Stroke volume (SV) measured by transthoracic echocardiography and CFTc by carotid Doppler were obtained at baseline (T1) and 20 minutes after the bolus (T2). Responders were defined by a ≥15% rise in SV. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of CFTc and its percentage change. Results An infective focus was identified in 61 patients (76.2%), with no source documented in 19 patients (23.8%). Thirty-two patients (40.0%) were responders. A baseline CFTc cut-off of ≤324.03 ms predicted responders with 71.9% sensitivity and 47.9% specificity (AUROC 0.563, 95% CI 0.435-0.691; p = 0.343). The percentage change in CFTc showed poor discrimination for fluid responsiveness (AUROC 0.568, 95% CI 0.436-0.700; p = 0.305) and corresponded weakly with the percentage change in SV (Spearman rho = 0.141; p = 0.213). Non-responders experienced recurrent hypotension more often and required earlier initiation of vasopressors. Conclusion In adults with new-onset shock, baseline CFTc did not usefully discriminate echocardiography-defined fluid responders, and the post-fluid change in CFTc showed weak correspondence with the change in stroke volume. CFTc should not be relied on alone to guide fluid resuscitation in this population.
Source: Cureus
Institution: All India Institute of Medical Sciences Rishikesh
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7215034713