Akademik Veri Yönetim Sistemi
American Journal of Emergency Medicine, cilt.108, ss.64-71, 2026 (SCI-Expanded, Scopus)
Background: Accurate stroke volume assessment is essential for guiding fluid resuscitation in critically ill patients. Although left ventricular outflow tract velocity-time integral (LVOT-VTI) is widely used, its acquisition is often challenging in the ED, whereas the easier-to-measure common carotid artery velocity-time integral (CCA-VTI) has limited supporting evidence in heterogeneous ED populations. This study aimed to evaluate the correlation and agreement between CCA-VTI and LVOT-VTI in critically ill ED patients undergoing fluid resuscitation. Methods: This prospective cross-sectional study was conducted in a tertiary-care ED between May and September 2025. Adult patients with critical illness and indications for intravenous fluid resuscitation were enrolled. Bedside ultrasound measurements of LVOT-VTI and CCA-VTI were obtained before and after fluid administration. Correlation was assessed using Spearman's coefficient, and agreement was evaluated using Bland–Altman analysis. Results: Fifty patients were included. LVOT-VTI and CCA-VTI showed strong correlation before fluid resuscitation (r = 0.88; p < 0.001), which increased after resuscitation (r = 0.92; p < 0.001). Among fluid responders (n = 24), correlation increased from r = 0.62 to r = 0.94. Percentage (Δ) changes in CCA-VTI were strongly correlated with LVOT-VTI (r = 0.74, p < 0.001). Bland–Altman analysis demonstrated good agreement between CCA-VTI and LVOT-VTI, with a mean bias of 0.12 cm before resuscitation (95% limits of agreement [LoA], −2.07 to 2.32 cm) and 0.08 cm after resuscitation (95% LoA, −1.26 to 1.41 cm). Conclusion: CCA-VTI demonstrated strong correlation and acceptable agreement with LVOT-VTI in critically ill ED patients and may serve as a practical bedside adjunct when LVOT imaging is challenging.