颈动脉校正血流时间综述

任 嵘1, 光文 辉*2
1、青海大学临床医学院
2、青海省人民医院

摘要


颈动脉校正血流时间（corrected flow time，FTc）作为无创血流动力学监测的核心指标，通过校正心率对原始血流时间（flow time，FT）的干扰，显著提升了容量状态评估的可靠性。传统FT定义为左心室射血期颈动脉多普勒频谱的持续时间，但其数值易受心率波动影响，尤其在心动过速（>100次/分）或心动过缓时可能误判容量状态。为此，Wodey提出校正公式（FTc=FT+1.29×（HR-60）），通过数学建模还原真实血流动力学特征，使其成为预测液体反应性的有效工具。近年来，颈动脉因位置表浅、探测便捷的优势，成为无创监测的热点靶血管，而可穿戴多普勒设备的创新进一步推动了FTc的实时动态监测能力。
　　FTc的临床价值在容量管理领域尤为突出。系统性研究证实，其预测液体反应性的合并敏感度达76%、特异度88%（AUC=0.91），显著优于传统参数在心律失常或低潮气量通气中的局限性。在特殊临床场景中，FTc展现出独特优势：机器人妇科手术中临界值357 ms时AUC为0.82；机械通气患者中不受PEEP水平干扰；老年患者全麻诱导前FTc<379.1 ms预警低血压的敏感度达72.2%。然而，该技术仍面临标准化不足、生理干扰显著及人群适用性差异等挑战。例如，穿孔性腹膜炎患者因感染应激导致FTc预测效能显著降低（AUC=0.70），而不同校正公式（如Bazett与Wodey）的应用差异可导致结果偏移达19%。

关键词


颈动脉校正血流时间；容量状态；测量公式

全文:

PDF


参考


[1]WANG J, LI Y, SU H, et al. Carotid artery corrected flow time and respiratory variations of peak blood flow velocity for prediction of hypotension after induction of general anesthesia in elderly patients [J]. BMC Geriatr, 2022, 22(1): 882.

[2]KENNY J S, HORNER C, ELFARNAWANY M, et al. Carotid Artery Corrected Flow Time Measured by Wearable Doppler Ultrasound Accurately Detects Changing Stroke Volume During the Passive Leg Raise in Ambulatory Volunteers Changes in corrected carotid flow time induced by recruitment maneuver predict fluid responsiveness in patients undergoing general anesthesia Evaluating corrected carotid flow time as a non-invasive parameter for trending cardiac output and stroke volume in cardiac surgery patients [J]. Front Biosci (Elite Ed), 2023, 15(2): 12.

[3]VAN HOUTE J, RAAIJMAAKERS A E, MOOI F J, et al. Evaluating corrected carotid flow time as a non-invasive parameter for trending cardiac output and stroke volume in cardiac surgery patients [J]. J Ultrasound, 2023, 26(1): 89-97.

[4]SINGLA D, GUPTA B, VARSHNEY P, et al. Role of carotid corrected flow time and peak velocity variation in predicting fluid responsiveness: a systematic review and meta-analysis [J]. Korean J Anesthesiol, 2023, 76(3): 183-93.

[5]TANG X, LIANG J, TAN D, et al. Value of carotid corrected flow time or changes value of FTc could be more useful in predicting fluid responsiveness in patients undergoing robot-assisted gynecologic surgery: a prospective observational study [J]. Front Med (Lausanne), 2024, 11: 1387433.

[6]WANG H, CHEN W, CHENG H, et al. VALUE OF CORRECTED FLOW TIME IN COMMON CAROTID ARTERY IN PREDICTING VOLUME RESPONSIVENESS UNDER MECHANICAL VENTILATION [J]. Shock, 2022, 58(1): 28-33.

[7]CHOWDHURY A R, THAKURIA R, MAITRA S, et al. Carotid artery corrected flow time and respiratory variation of blood flow peak velocity for prediction of hypotension after induction of general anesthesia in adult patients undergoing emergency laparotomy for peritonitis: A prospective, observational study [J]. J Anaesthesiol Clin Pharmacol, 2023, 39(3): 444-50.

[8]KIMURA A, SUEHIRO K, JURI T, et al. Changes in corrected carotid flow time induced by recruitment maneuver predict fluid responsiveness in patients undergoing general anesthesia Evaluating corrected carotid flow time as a non-invasive parameter for trending cardiac output and stroke volume in cardiac surgery patients [J]. J Clin Monit Comput, 2022, 36(4): 1069-77.

[9]JELIC T, CHENKIN J. Carotid Flow Time Compared with Invasive Monitoring as a Predictor of Volume Responsiveness in ICU patients [J]. POCUS J, 2023, 8(2): 212-6.

[10]JUNG S, KIM J, NA S, et al. Ability of Carotid Corrected Flow Time to Predict Fluid Responsiveness in Patients Mechanically Ventilated Using Low Tidal Volume after Surgery [J]. J Clin Med, 2021, 10(12).

[11]CHEONG I, MERLO P M, TAMAGNONE F M, et al. Correlation between corrected carotid flow time and left ventricular outflow tract velocity-time integral using a novel technique Carotid Flow Time Compared with Invasive Monitoring as a Predictor of Volume Responsiveness in ICU patients [J]. J Clin Ultrasound, 2025, 53(1): 97-102.

[12]KIM D H, SHIN S, KIM N, et al. Carotid ultrasound measurements for assessing fluid responsiveness in spontaneously breathing patients: corrected flow time and respirophasic variation in blood flow peak velocity Correction: Correlation of carotid corrected flow time and respirophasic variation in blood flow peak velocity with stroke volume variation in elderly patients under general anaesthesi [J]. Br J Anaesth, 2018, 121(3): 541-9.

[13]VAN HOUTE J, EERDEKENS R, MANNING F, et al. Is the Corrected Carotid Flow Time a Clinically Acceptable Surrogate Hemodynamic Parameter for the Left Ventricular Ejection Time? Corrected flow time: a noninvasive ultrasound measure to detect preload reduction by nitroglycerin A new modality for the estimation of corrected flow time via electrocardiography as an alternative to Doppler ultrasonography [J]. Ultrasound Med Biol, 2024, 50(4): 528-35.

[14]MOHAMMADINEJAD P, HOSSEIN-NEJAD H. Calculation of corrected flow time: Wodey’s formula vs. Bazett’s formula [J]. J Crit Care, 2018, 44: 154-5.

[15]HOSSEIN-NEJAD H, BANAIE M, DAVARANI S S, et al. Assessment of corrected flow time in carotid artery via point-of-care ultrasonography: Reference values and the influential factors Reliability, Laterality and the Effect of Respiration on the Measured Corrected Flow Time of the Carotid Arteries [J]. J Crit Care, 2017, 40(1): 46-51.

[16]HOSSEIN-NEJAD H, MOHAMMADINEJAD P, ZEINODDINI A, et al. A new modality for the estimation of corrected flow time via electrocardiography as an alternative to Doppler ultrasonography [J]. Ann Noninvasive Electrocardiol, 2018, 23(1).

[17]BEIER L, DAVIS J, ESENER D, et al. Carotid Ultrasound to Predict Fluid Responsiveness: A Systematic Review [J]. J Ultrasound Med, 2020, 39(10): 1965-76.

[18]KIM D H, SHIN S, KIM N, et al. Carotid ultrasound measurements for assessing fluid responsiveness in spontaneously breathing patients: corrected flow time and respirophasic variation in blood flow peak velocity Corrected carotid flow time and passive leg raise as a measure of volume status [J]. Br J Anaesth, 2018, 121(3): 541-9.

[19]KARADADAŞ S, ÇORBACıOĞLU Ş K, ÇEVIK Y, et al. Assessment of the carotid artery Doppler flow time in patients with acute upper gastrointestinal bleeding [J]. Turk J Emerg Med, 2020, 20(1): 35-41.

[20]CHEBL R B, WUHANTU J, KIBLAWI S, et al. Corrected carotid flow time and passive leg raise as a measure of volume status [J]. Am J Emerg Med, 2019, 37(8): 1460-5.

[21]DOCTOR M, SIADECKI S D, COOPER D, JR., et al. Reliability, Laterality and the Effect of Respiration on the Measured Corrected Flow Time of the Carotid Arteries [J]. J Emerg Med, 2017, 53(1): 91-7.

[22]JUDSON P I, ABHILASH K P P, PICHAMUTHU K, et al. Evaluation of Carotid Flow Time to Assess Fluid Responsiveness in the Emergency Department [J]. J Med Ultrasound, 2021, 29(2): 99-104.

[23]SIDOR M, PREMACHANDRA L, HANNA B, et al. Carotid Flow as a Surrogate for Cardiac Output Measurement in Hemodynamically Stable Participants [J]. J Intensive Care Med, 2020, 35(7): 650-5.

[24]DEMIR I, TURKTAN M, GULEC E, et al. The predictive role of carotid artery flow time for anesthesia-induced hypotension in high-risk elderly patients [J]. J Clin Monit Comput, 2024, 38(4): 859-67.

[25]HUANG S, LIAO Z, CHEN A, et al. Effect of carotid corrected flow time combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients: a prospective cohort study [J]. Int J Surg, 2024, 110(2): 799-809.

[26]LI M, LI F, YU J, et al. The impact of pre-rehydration guided by carotid corrected flow time on hypotension prevention following general anesthesia induction in patients undergoing gastrointestinal surgery: a prospective randomized controlled trial [J]. Front Med (Lausanne), 2024, 11: 1416574.

[27]JURI T, SUEHIRO K, YASUDA S, et al. Changes in the corrected carotid flow time can predict spinal anesthesia-induced hypotension in patients undergoing cesarean delivery: an observational study Carotid Artery Corrected Flow Time and Respiratory Variations of Peak Blood Flow Velocity for Prediction of Hypotension After Induction of General Anesthesia in Adult Patients Undergoing Elective Surgery: A Prospective Observational Study Carotid corrected flow time and Doppler shock index for prediction of post-induction hypotension in patients undergoing elective abdominal surgery: a prospective observational study [J]. J Anesth, 2024, 38(1): 105-13.

[28]SUN T, HUI K, REN L, et al. Carotid corrected flow time and Doppler shock index for prediction of post-induction hypotension in patients undergoing elective abdominal surgery: a prospective observational study [J]. Perioper Med (Lond), 2025, 14(1): 38.

[29]TANG X, CHEN Q, HUANG Z, et al. Comparison of the carotid corrected flow time and tidal volume challenge for assessing fluid responsiveness in robot-assisted laparoscopic surgery The association between carotid flow time and fluid responsiveness in children under general anesthesia [J]. J Robot Surg, 2023, 17(6): 2763-72.

[30]XU L, DAI S, SHEN J, et al. The predictive ability of carotid artery corrected flow time and respirophasic variation in blood flow peak velocity measured by ultrasonography for fluid responsiveness in parturients for cesarean delivery [J]. Minerva Anestesiol, 2020, 86(10): 1039-46.

[31]KIM H J, CHOI Y S, KIM S H, et al. Predictability of preoperative carotid artery-corrected flow time for hypotension after spinal anaesthesia in patients undergoing caesarean section: A prospective observational study Effect of carotid corrected flow time combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients: a prospective cohort study [J]. Eur J Anaesthesiol, 2021, 38(4): 394-401.

[32]杨继光，卢海洋.颈动脉校正血流时间评估腹腔镜结直肠手术患者容量反应性的有效性[J].临床麻醉学杂志，2022，38（03）：242-245.


Refbacks

  • 当前没有refback。