Validity of Corrected Flow Time (FTc) as a Predictor of Fluid Responsiveness in Patients with Sepsis-induced Hypotension

Jung,  Sang Min; Ryu,  Seung; Cho,  Yong Chul; Lee,  Seung Han; Lim,  Jung Soo; Yun,  Sang Yeol; Yoo,  In Sool

J Korean Soc Emerg Med > Volume 23(1); 2012 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2012;23(1): 56-61.

Validity of Corrected Flow Time (FTc) as a Predictor of Fluid Responsiveness in Patients with Sepsis-induced Hypotension

Sang Min Jung, Seung Ryu, Yong Chul Cho, Seung Han Lee, Jung Soo Lim, Sang Yeol Yun, In Sool Yoo

Department of Emergency Medicine, Chungnam National University School of Medicine, Korea. rs0505@cnuh.co.kr

ABSTRACT

PURPOSE:
To determine the validity of corrected flow time (FTc) as a predictor of fluid responsiveness for patients with sepsis-induced hypotension in the emergency department.
METHODS:
A total of 26 adult patients, who presented in the emergency department with sepsis-induced hypotension with spontaneous breathing, were enrolled in this prospective, interventional study. These patients were monitored by Esophageal Doppler (ED); FTc, central venous pressure (CVP), stroke volume index (SVI), and inferior vena cava diameter (IVCD) were measured before and after fluid challenge. Responsiveness to fluid challenge was defined as an SVI increase> or =10%. Receiver operating characteristic (ROC) curves were constructed and compared to evaluate the overall performance of preload indices (CVP, FTc, IVCD) in terms of predicting fluid responsiveness.
RESULTS:
Of the hemodynamic parameters initially measured, there were statistically significant differences in FTc and CVP between the responsive and unresponsive groups. Before and after fluid challenge, noticeable changes were observed in mean arterial pressure (MAP), CVP and IVCD between the two groups. Only the responsive group demonstrated statistical difference in FTc. The areas under the curves for FTc (0.870; 95% CIs, 0.708-0.979; p=.009) were significantly greater than those for CVP and IVCD.
CONCLUSION:
The corrected flow time (FTc) method may be a good predictor of fluid responsiveness relative to sepsis-induced hypotension for patients in the emergency department.

Key words: Esophageal Doppler, Corrected flow time, Sepsis, Emergency department