Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2026
Preoperative corrected carotid flow time is associated with spinal anesthesia-induced hypotension in hypertensive patients: A prospective observational study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tutar Mahmut Sami, Mermer Hasan Alp, Oner Ali Aydin, Birler Ali Ihsan, Mutluay Yusuf Salih, Satici Muhammed Halit, Yildiz Munise, Kozanhan Betul
Аннотация
BACKGROUND: Spinal anesthesia-induced hypotension (SAIH) is common in hypertensive patients, yet reliable preoperative markers remain limited. Corrected carotid flow time (CCFT) is a Doppler-derived index influenced by preload and ventricular ejection timing, but its association with SAIH in this population has not been established.
OBJECTIVE: To evaluate whether preoperative CCFT is independently associated with SAIH in hypertensive patients undergoing spinal anesthesia.
DESIGN: Single-center prospective observational study.
PATIENTS: In total, 110 hypertensive adults scheduled for lower abdominal or lower extremity surgery under spinal anesthesia.
SETTING: University hospital, operating room.
INTERVENTIONS: Preoperative carotid and brachial ultrasound assessments (CCFT, carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), carotid blood flow, and internal jugular vein collapsibility index) were performed. Hemodynamics were recorded for 30 min after spinal injection.
MAIN OUTCOME MEASURES: Primary outcome: SAIH (≥20% decrease in systolic blood pressure or SBP <90 mmHg sustained for ≥1 minute).
SECONDARY OUTCOMES: hemodynamic trends and discriminative performance of ultrasound parameters.
RESULTS: SAIH occurred in 54 patients (49.1%). CCFT was shorter in patients who developed hypotension (326.5 ± 71.3 vs 437.3 ± 82.9 ms, p < 0.001). In the primary multivariable model including CIMT, FMD, and beta-blocker use, CCFT remained independently associated with SAIH (adjusted odds ratio 0.980 per 1-ms increase, 95% confidence interval (CI) 0.973-0.988, p < 0.001). CCFT alone had an area under the curve (AUC) of 0.854 (95% CI 0.785-0.924); the 358.5-ms cut-off had 74.1% sensitivity and 87.5% specificity. A clinical model including age, baseline SBP, and beta-blocker use had an AUC of 0.572 (95% CI 0.465-0.679); adding CCFT increased the AUC to 0.866 (95% CI 0.799-0.932; paired comparison p < 0.001).
CONCLUSIONS: Preoperative CCFT was independently associated with SAIH and improved discrimination when added to a parsimonious clinical model. The cohort-derived threshold requires external validation before clinical implementation.
TRIAL REGISTRATION: ClinicalTrials.gov (https://clinicaltrials.gov/), NCT06749184.
OBJECTIVE: To evaluate whether preoperative CCFT is independently associated with SAIH in hypertensive patients undergoing spinal anesthesia.
DESIGN: Single-center prospective observational study.
PATIENTS: In total, 110 hypertensive adults scheduled for lower abdominal or lower extremity surgery under spinal anesthesia.
SETTING: University hospital, operating room.
INTERVENTIONS: Preoperative carotid and brachial ultrasound assessments (CCFT, carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), carotid blood flow, and internal jugular vein collapsibility index) were performed. Hemodynamics were recorded for 30 min after spinal injection.
MAIN OUTCOME MEASURES: Primary outcome: SAIH (≥20% decrease in systolic blood pressure or SBP <90 mmHg sustained for ≥1 minute).
SECONDARY OUTCOMES: hemodynamic trends and discriminative performance of ultrasound parameters.
RESULTS: SAIH occurred in 54 patients (49.1%). CCFT was shorter in patients who developed hypotension (326.5 ± 71.3 vs 437.3 ± 82.9 ms, p < 0.001). In the primary multivariable model including CIMT, FMD, and beta-blocker use, CCFT remained independently associated with SAIH (adjusted odds ratio 0.980 per 1-ms increase, 95% confidence interval (CI) 0.973-0.988, p < 0.001). CCFT alone had an area under the curve (AUC) of 0.854 (95% CI 0.785-0.924); the 358.5-ms cut-off had 74.1% sensitivity and 87.5% specificity. A clinical model including age, baseline SBP, and beta-blocker use had an AUC of 0.572 (95% CI 0.465-0.679); adding CCFT increased the AUC to 0.866 (95% CI 0.799-0.932; paired comparison p < 0.001).
CONCLUSIONS: Preoperative CCFT was independently associated with SAIH and improved discrimination when added to a parsimonious clinical model. The cohort-derived threshold requires external validation before clinical implementation.
TRIAL REGISTRATION: ClinicalTrials.gov (https://clinicaltrials.gov/), NCT06749184.