Electrical Cardiometry versus Carotid Doppler as an Assessment Tools of Fluid Responsiveness in Critically Ill Septic Patients

Background: Sepsis is a life-threatening syndrome characterized by a dysregulated immune response to infection, often resulting in multi-organ dysfunction. Rapid and accurate assessment of fluid responsiveness is crucial for optimal management of septic patients. This study aimed to compare the effectiveness of two noninvasive techniques—electrical cardiometry (EC) and carotid Doppler ultrasound—in predicting fluid responsiveness in critically ill septic patients. Methods: This clinical trial was conducted on 50 adult patients (≥18 years) admitted to the ICU at Benha University Hospitals with sepsis or septic shock. Patients were classified into two equal groups based on their response to a passive leg raising (PLR) test: Group A (fluid responders) and Group B (non-responders). Hemodynamic parameters were measured using carotid Doppler (BFCCA) and EC (COPEC) before and after PLR. Results: The BFCCA demonstrated an AUC of 0.730 in predicting fluid responsiveness post-PLR (P=0.003) at a cutoff >608, yielding 88% sensitivity and 56% specificity. The percentage change in BFCCA (%Δ BFCCA 1) had a higher AUC of 0.843 (P<0.001) at a cutoff <20.04, with 84% sensitivity and 72% specificity. The COPEC showed an AUC of 0.748 (P=0.003) at a cutoff <7, with 80% sensitivity and 48% specificity, while %Δ COPEC 1 had the highest AUC of 0.864 (P<0.001) at a cutoff <14.28, with 72% sensitivity and 80% specificity. Conclusion:Both carotid Doppler and EC are reliable, noninvasive methods for assessing fluid responsiveness in septic patients, with %Δ COPEC and %Δ BFCCA showing the strongest predictive values.