Despite the acceptance of carotid ultrasound for predicting patients’ fluid responsiveness in critical care and anesthesia, its efficacy for predicting hypotension and fluid responsiveness remains unclear in the perioperative setting. Electronic databases were searched from inception to May 2023 to identify observational studies focusing on the use of corrected blood flow time (FTc) and respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak) for assessing the risks of hypotension and fluid responsiveness. Using FTc as a predictive tool (four studies), the analysis yielded a pooled sensitivity of 0.82 (95% confidence interval (CI): 0.72 to 0.89) and specificity of 0.94 (95% CI: 0.88 to 0.97) for the risk of hypotension (area under curve (AUC): 0.95). For fluid responsiveness, the sensitivity and specificity of FTc were 0.79 (95% CI: 0.72 to 0.84) and 0.81 (95% CI: 0.75 to 0.86), respectively (AUC: 0.87). In contrast, the use of ΔVpeak to predict the risk of fluid responsiveness showed a pooled sensitivity of 0.76 (95% CI: 0.63 to 0.85) and specificity of 0.74 (95% CI: 0.66 to 0.8) (AUC: 0.79). The current meta-analysis provides robust evidence supporting the high diagnostic accuracy of FTc in predicting perioperative hypotension and fluid responsiveness, which requires further studies for verification.

Background: The discovery of driver mutations has transformed advanced non–small cell lung cancer treatment, with ALK (anaplastic lymphoma kinase)–rearranged patients achieving longest overall survival. However, the risk of cancer therapy–related cardiovascular diseases (CTRCVDs) is underrecognized, particularly comparing second‐generation ALK–tyrosine kinase inhibitors alectinib and brigatinib to the third‐generation tyrosine kinase inhibitor lorlatinib, which offers the longest progression‐free survival. We aimed to compare CTRCVDs risks among patients with lung cancer receiving ALK‐tyrosine kinase inhibitor, assess incidence trends, and identify clinical risk factors associated with ALK‐tyrosine kinase inhibitor‐related CTRCVDs. Methods: This retrospective cohort study of 946 848 adults with lung cancer (2010–2024) using TriNetX compared CTRCVDs risk in ALK‐mutated patients treated with lorlatinib versus brigatinib/alectinib. After excluding ROS1‐mutated cases and 1:1 propensity score matching, 744 patients per group were analyzed. CTRCVDs, defined as myocardial infarction, stroke, arterial embolism, or heart failure, were evaluated with Kaplan–Meier analysis and Cox proportional hazards models over 2 years. Results: Lorlatinib treatment was associated with a significantly increased risk of CTRCVDs (hazard ratio [HR], 3.00 [95% CI, 1.65–5.45]; P <0.001). Incidence rose from 2.2% at 6 months to 6.6% at 3 years, versus 1.7% and 2.2% in the brigatinib/alectinib cohort. Multivariable analysis identified advanced age (HR, 1.02 [95% CI, 1.00–1.04]; P =0.04), atrial fibrillation/flutter history (HR, 2.39 [95% CI, 1.13–5.07]; P =0.002), and lorlatinib use (HR, 2.42 [95% CI, 1.57–3.72]; P <0.001) as independent predictors. Conclusion: These findings underscore the importance of routine cardiovascular monitoring, particularly in older patients and those with atrial arrhythmias.