Key result
Minimally invasive cardiac output monitors detected significant stroke volume reductions after 2.5% to 12.5% blood loss in awake volunteers, with AUCs of 0.68-0.82 for predicting >10% blood loss.
Why the study?
Do minimally invasive cardiac output devices detect hypovolaemia by measuring stroke volume reduction in conscious volunteers?
Do minimally invasive cardiac output devices detect hypovolaemia by measuring stroke volume reduction in conscious volunteers?
Minimally invasive cardiac output devices can detect early blood loss through stroke volume reduction in awake individuals, suggesting potential utility for guiding fluid replacement in conscious patients with suspected hypovolaemia.
May support early hypovolaemia detection in conscious patients; hypothesis-generating and requires validation before clinical adoption.
It is important to detect and treat hypovolaemia; however, detection is particularly challenging in the conscious, spontaneously breathing patient. Eight healthy male volunteers were monitored using four minimally invasive monitors: Vigileo FloTrac(™) ; LiDCOrapid(™) ; USCOM 1A; and CardioQ(™) oesophageal Doppler. Monitor output and clinical signs were recorded during incremental venesection of 2.5% estimated blood volume aliquots to a total of 20% blood volume removed. A statistically significant difference from baseline stroke volume was detected after 2.5% blood loss using the LiDCO (p = 0.007), 7.5% blood loss using the USCOM (p = 0.019), and 12.5% blood loss using the CardioQ (p = 0.046) and the FloTrac (p = 0.028). Receiver operator characteristic curves for predicting > 10% blood loss had areas under the curve of 0.68-0.82. The minimally invasive cardiac output devices tested can detect blood loss by a reduction in stroke volume in awake volunteers, and may have a role in guiding fluid replacement in conscious patients with suspected hypovolaemia.
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O’Loughlin et al. (2015) studied Hypovolaemia (n=8). Minimally invasive cardiac output monitors (Vigileo FloTrac, LiDCOrapid, USCOM 1A, CardioQ) vs. Baseline was evaluated on Statistically significant difference from baseline stroke volume. Minimally invasive cardiac output monitors detected significant stroke volume reductions after 2.5% to 12.5% blood loss in awake volunteers, with AUCs of 0.68-0.82 for predicting >10% blood loss.
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