O025 - COMMON CAROTID ARTERY BLOOD FLOW AS A NOVEL EARLY MORTALITY INDICATOR IN ICU PATIENTS

O025

COMMON CAROTID ARTERY BLOOD FLOW AS A NOVEL EARLY MORTALITY INDICATOR IN ICU PATIENTS

T. Narita^1,2,*, K. Fukatsu^2,3, S. Murakoshi^2,3,4, M. Noguchi³, R. Inoue³, K. kono³, N. Matsumoto², S. Tsuihiji³, T. Asada⁵, M. Yamamoto⁵, R. Horie⁵, R. Inokuchi⁵, K. Doi⁵, Y. Baba¹

¹Gastrointestinal Surgery, ²Operating Room Management and Surgical Metabolism, The University of Tokyo, ³Surgical Center, The University of Tokyo Hospital, Tokyo, ⁴Faculty of Health & Social Work, The Kanagawa University of Human Services, Kanagawa, ⁵Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan

Rationale: In critically ill patients, gut blood flow(BF) is decreased while cerebral BF is maintained to preserve brain perfusion. However, no studies have directly assessed both gut and cerebral BF. We conducted a prospective observational study to assess BF in the common carotid artery(CCA) and superior mesenteric artery(SMA), and clarify  their relation to clinical outcomes.

Methods: We enrolled 60 critically ill patients admitted to the ICU at The University of Tokyo Hospital(July 2023 - June 2024, Ethics No. 2023049NI). CCA and SMA BF were assessed using ultrasound within 24 and 48 hours, and on the 4th and 7th days. Physical and hematological parameters, SOFA and APACHE II scores, and clinical course were recorded. BF kinetics were compared between survivors(>10 days) and non-survivors, and associations between BF and clinical parameters were analyzed.

Results: CCA and SMA BF showed no significant changes after admission(linier mixed model and regression analysis). No significant correlations were observed between BF and physical or hematological findings(Spearman's rank correlation). Seven patients died within 10 days. In these patients, CCA BF within 24 hours was significantly lower than BF in survivors, while SMA BF was not different. Sustained decrease in CCA BF until 48 hours was associated with early death. ROC analysis showed that CCA BF within 24 hours had a higher AUC(0.80175) than SOFA(0.50539) and APACHE II(0.54043) for predicting early mortality.

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Conclusion: This is the first study to examine cerebral and gut BF in ICU patients and their prognostic implications. Early reductions in CCA BF precede mortality more reliably than exsting scores. While it is unclear whether reduced CCA BF contributes to mortality or reflects the severity of illness, routine BF assessment may provide a valuable tool for early mortality prediction in ICU patients. Further research is needed to establish its clinical utility.

Disclosure of Interest: T. Narita Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, K. Fukatsu Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, S. Murakoshi Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, M. Noguchi Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, R. Inoue Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, K. kono Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, N. Matsumoto Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, S. Tsuihiji Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, T. Asada Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, M. Yamamoto Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, R. Horie Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, R. Inokuchi Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, K. Doi Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none, Y. Baba Grant / Research Support from: none, Consultant for: none, Speakers Bureau of: none, Shareholder of: none, Paid Instructor at: none, Other: none