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Ultrasound-measured brachial artery reactive hyperemia in critically ill patients: an observational study.
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ABSTRACT: Background
Ultrasound-measured brachial artery reactive hyperemia (RH) is independently predictive of hospital mortality in critically ill patients with sepsis. Its association with mortality is uncertain in critically ill patients in general.Methods
This was a combined case-control and prospective cohort study. Ultrasound was used to measure brachial artery reactive hyperemia in 150 critically ill patients at a single academic medical center and in 44 control subjects without acute illness. Measurements were compared in cases versus controls, septic vs. non-septic critically ill patients, and hospital survivors vs. non-survivors. Follow-up measurements were obtained 3-5 days later in a sub-sample of patients.Results
RH was calculated as the percent change in pre- vs. post-ischemic brachial artery velocity-time integral measured by Doppler ultrasound. RH was impaired in critically ill compared to control subjects (194 [179-210] vs. 369 [314-433]%, p < 0.001; results expressed as mean [95% confidence interval]) but similar in septic compared to non-septic patients (196 [177-217] vs. 199 [170-233], p = 0.88). RH was significantly lower in hospital non-survivors compared to survivors (144 [120-173] vs. 204 [187-222], p = 0.003). Multivariable analysis showed that the difference between survivors and non-survivors was not confounded by age or comorbidities (odds ratio for hospital death = 0.26 per log unit rise in RH, 95% confidence interval = 0.08-0.83, p = 0.02). The magnitude of RH improved over 3-5 days in hospital survivors (n = 63, 204 [180-232] vs. 239 [208-275], p = 0.02), but did not change in non-survivors (n = 11, 133 [107-165] vs. 128 [75-220].Conclusions
Reactive hyperemia of the brachial artery is impaired in undifferentiated critically ill patients, lower in non-survivors compared to survivors, and independently associated with hospital mortality. Brachial artery reactive hyperemia improves significantly over time in survivors but not in non-survivors.
SUBMITTER: Storms CR
PROVIDER: S-EPMC12465633 | biostudies-literature | 2025 Sep
REPOSITORIES: biostudies-literature
Publications
Ultrasound-measured brachial artery reactive hyperemia in critically ill patients: an observational study.
Critical care (London, England) 20250925 1
<h4>Background</h4>Ultrasound-measured brachial artery reactive hyperemia (RH) is independently predictive of hospital mortality in critically ill patients with sepsis. Its association with mortality is uncertain in critically ill patients in general.<h4>Methods</h4>This was a combined case-control and prospective cohort study. Ultrasound was used to measure brachial artery reactive hyperemia in 150 critically ill patients at a single academic medical center and in 44 control subjects without ac ...[more]
