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. 2021 Dec 8;8(12):203.
doi: 10.3390/bioengineering8120203.

A Wireless Wearable Doppler Ultrasound Detects Changing Stroke Volume: Proof-of-Principle Comparison with Trans-Esophageal Echocardiography during Coronary Bypass Surgery

Jon-Émile Stuart Kenny  1   2 , Geoffrey Clarke  1   2 , Matt Myers  2 , Mai Elfarnawany  2 , Andrew M Eibl  1   2 , Joseph K Eibl  1   2   3 , Bhanu Nalla  1   3 , Rony Atoui  1   3
Affiliations

A Wireless Wearable Doppler Ultrasound Detects Changing Stroke Volume: Proof-of-Principle Comparison with Trans-Esophageal Echocardiography during Coronary Bypass Surgery

Jon-Émile Stuart Kenny et al. Bioengineering (Basel). .

Abstract

Background: A novel, wireless, ultrasound biosensor that adheres to the neck and measures real-time Doppler of the carotid artery may be a useful functional hemodynamic monitor. A unique experimental set-up during elective coronary artery bypass surgery is described as a means to compare the wearable Doppler to trans-esophageal echocardiography (TEE).

Methods: A total of two representative patients were studied at baseline and during Trendelenburg position. Carotid Doppler spectra from the wearable ultrasound and TEE were synchronously captured. Areas under the receiver operator curve (AUROC) were performed to assess the accuracy of changing common carotid artery velocity time integral (ccVTI∆) at detecting a clinically significant change in stroke volume (SV∆).

Results: Synchronously measuring and comparing Doppler spectra from the wearable ultrasound and TEE is feasible during Trendelenburg positioning. In two representative cardiac surgical patients, the ccVTI∆ accurately detected a clinically significant SV∆ with AUROCs of 0.89, 0.91, and 0.95 when single-beat, 3-consecutive beat and 10-consecutive beat averages were assessed, respectively.

Conclusion: In this proof-of-principle research communication, a wearable Doppler ultrasound system is successfully compared to TEE. Preliminary data suggests that the diagnostic accuracy of carotid Doppler ultrasonography at detecting clinically significant SV∆ is enhanced by averaging more cardiac cycles.

Keywords: carotid doppler; fluid responsiveness; functional hemodynamic monitoring; trans-esophageal echocardiography.

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Conflict of interest statement

J.-É.S.K., G.C., M.M., M.E., A.M.E. and J.K.E. work for Flosonics Medical, the start-up building the wearable Doppler ultrasound. R.A. and B.N. declare no competing interests.

Figures

Figure 1
Figure 1
(A). The wireless, wearable Doppler ultrasound on a volunteer. (B). The experimental set-up with the novel, wearable biosensor (FloPatch™). PW is pulse wave; LVOT is left ventricular outflow tract; CW is continuous wave; app is application; USB is universal serial bus; Win10PC is Windows 10 personal computer.
Figure 2
Figure 2
Results from the proof-of-principle study. (A) Simultaneously acquired Doppler spectra from the wearable Doppler and the trans-esophageal echocardiogram (TEE) during arrhythmia from one of the studied patients. (B) shows the area under the receiver operator curves for beat-to-beat, 3 consecutively averaged and 10 consecutively averaged cardiac cycles for the two patients. (C–E) shows the boxplots and optimal ccVTI∆ thresholds for discriminating +10% SV∆ from <10% SV∆ across the different degrees of consecutive beat averaging.
See this image and copyright information in PMC

References

    1. Kenny J.É.S., Munding C.E., Eibl J.K., Eibl A.M., Long B.F., Boyes A., Yin J., Verrecchia P., Parrotta M., Gatzke R., et al. A novel, hands-free ultrasound patch for continuous monitoring of quantitative Doppler in the carotid artery. Sci. Rep. 2021;11:1–11. - PMC - PubMed
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