No abstract

The world has changed due to COVID-19 pandemic. Global spread of COVID-19 has overwhelmed all health systems and has incurred widespread social and economic disruption. The authorities are struggling to ramp up the healthcare systems to overcome it. Anaesthesiologists are facing long duty hours, have fear of bringing disease home to their families, being companion to critically ill patients on long term life support, being on front line of this pandemic crisis, may take toll on all aspects of health of corona warriors- physical, mental, social as well as the emotional.At this juncture, we must pause and ask this question to ourselves, “Buried under stress, are we okay?”

The automated surveillance was easy and useful for data entry and analysis. Surveillance had a significant impact on reduction of HAIs and mortality in trauma patients.

Background: Over a period, it was realized that dynamic parameters are more suitable as compared to static paraments in predicting fluid responsiveness. Still, most of these techniques require special equipment and are still minimally invasive. So, attention has recently been focused on the use of carotid artery ultrasound paraments like carotid corrected flow time (FTc), and peak velocity variation (∆V peak). Methods:We searched PubMed and EMBASE databases for articles studying the diagnostic accuracy of FTc or ∆V peak in predicting fluid responsiveness. Two independent authors performed the search and selected studies published up to May 2022. Studies were analysed based on inclusion and exclusion criteria with Rayyan (Rayyan Systems Inc. 2022). Results:We selected 10 (n=438) studies which fulfilled the inclusion criteria. Studies were divided in those studying FTc and those involving assessment of ∆V peak. Five studies (six data sets) assessed FTc. The pooled sensitivity of FTc was 0.758, specificity was 0.883. The SROC curve for FTc had an area under the curve (AUC) of 0.9092 with a Q value of 0.8412. Seven studies that calculated ∆Vpeak. The pooled sensitivity for ∆Vpeak was 0.828, specificity was 0.805. The SROC curve had an AUC of 0.8941 with a Q value of 0.8250. Conclusions:Our meta-analysis has shown that both carotid corrected flow time and peak velocity variation are useful in predicting fluid responsiveness in anaesthesia and critical care settings with good specificity and sensitivity.