Abstract

Quantitative Doppler ultrasound of the carotid artery has been proposed as an instantaneous surrogate for monitoring rapid changes in left ventricular output. Tracking immediate changes in the arterial Doppler spectrogram has value in acute care settings such as the emergency department, operating room and critical care units. We report a novel, hands-free, continuous-wave Doppler ultrasound patch that adheres to the neck and tracks Doppler blood flow metrics in the common carotid artery using an automated algorithm. String and blood-mimicking test objects demonstrated that changes in velocity were accurately measured using both manually and automatically traced Doppler velocity waveforms. In a small usability study with 22 volunteer users (17 clinical, 5 lay), all users were able to locate the carotid Doppler signal on a volunteer subject, and, in a subsequent survey, agreed that the device was easy to use. To illustrate potential clinical applications of the device, the Doppler ultrasound patch was used on a healthy volunteer undergoing a passive leg raise (PLR) as well as on a congestive heart failure patient at resting baseline. The wearable carotid Doppler patch holds promise because of its ease-of-use, velocity measurement accuracy, and ability to continuously record Doppler spectrograms over many cardiac and respiratory cycles.

Highlights

  • Quantitative Doppler ultrasound of the carotid artery has been proposed as an instantaneous surrogate for monitoring rapid changes in left ventricular output

  • The heart should respond to increased venous return by stretching the cardiac wall at end-diastole, which increases cardiac preload, and increasing left ventricular contraction in order to pump the larger fluid volume through the circulatory system; this is known as the Frank-Starling ­relationship[2,3,4]

  • Using Doppler ultrasonography, stroke volume is measured as the product of the left ventricular output tract (LVOT) area and stroke distance, which is the distance the blood travels during a single cardiac cycle

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Summary

Introduction

Quantitative Doppler ultrasound of the carotid artery has been proposed as an instantaneous surrogate for monitoring rapid changes in left ventricular output. Transthoracic and esophageal Doppler have been used to measure VTI in the descending aorta to infer changes in left ventricular stroke volume, but this requires cart-based ultrasound imaging equipment and advanced ­training[24]. In response to these shortcomings, others have successfully used quantitative PW Doppler in the common carotid artery as a surrogate for changing SV to predict the haemodynamic response to PLR over short time periods (i.e., seconds-to-minutes)[25,26,27]

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