Quantitative response of volumetric variables measured by a new ultrasound dilution method in a juvenile model of hemorrhagic shock and resuscitation.
Abstract: New volumetric variables of preload, such as total end-diastolic volume index (TEDVI) and active circulation volume index (ACVI) and central blood volume index (CBVI), may represent good indicators of preload and predictors of fluid responsiveness. During acute changes of intravascular volume these variables would allow a more accurate intervention. Objective: The aim of the present study was to investigate the changes in TEDVI, ACVI, CBVI in a juvenile model of hemorrhagic shock and resuscitation. Methods: Twelve anaesthetized ponies (3-8 months of age) were studied at normovolaemia (BASE), after blood withdrawal to mean arterial pressure (MAP) of 40 mmHg (HEMO), after infusion of norepinephrine to reach a MAP of ± 10% of baseline (HE-NE), and after retransfusion of shed blood (RESU). TEDVI, ACVI, CBVI were measured by Ultrasound Dilution (UD) technology with CoStatus device. Data were analyzed using 1-way (ANOVA) followed by Bonferroni's multiple pairwise comparisons. Evaluation of dependence between CoStatus volumetric variables and stroke volume index (SVI) were performed using the linear regression analysis and calculating the r(2) coefficient of determination. Results: TEDVI and ACVI changed significantly during HEMO and RESU status. NE administration induced MAP and CVP significant changes, whereas TEDVI and ACVI remained unchanged. CBVI showed high variability and seemed to be inconsistent on the identification of the volume status. In the correlation analysis, only TEDVI consistently correlated with SVI and volume induced SVI changes. Conclusions: In this animal model, TEDVI and ACVI were superior to CBVI in consistently reflecting hemorrhage. TEDVI but not ACVI and CBVI correlated with volume-induced changes in SVI. NE administration did not affect this correlation.
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Publication Date: 2012-01-25 PubMed ID: 22281224DOI: 10.1016/j.resuscitation.2012.01.014Google Scholar: Lookup
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Summary
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This research explores how specific volumetric variables can be used to accurately gauge and respond to acute changes in intravascular volume, particularly in cases of hemorrhagic shock and resuscitation. The study was conducted on anesthetized ponies and measured data using an ultrasound dilution technology.
Study Objective
- The primary aim of the study was to ascertain how total end-diastolic volume index (TEDVI), active circulation volume index (ACVI), and central blood volume index (CBVI) change in a juvenile model of hemorrhagic shock and subsequent resuscitation.
Methods Used in the Study
- The researchers used twelve ponies aged between 3-8 months, who were anaesthetized for the study.
- The ponies were studied in four different conditions, when they were normovolaemic (BASE), after blood was withdrawn enough to allow mean arterial pressure (MAP) of 40mmHg (HEMO), after being infused with norepinephrine to reach a MAP of ± 10% of baseline (HE-NE), and finally, after retransfusion of previously shed blood (RESU).
- TEDVI, ACVI, CBVI were measured using an Ultrasound Dilution (UD) technology with a CoStatus device.
- The collected data were then analyzed using 1-way ANOVA and Bonferroni’s multiple pairwise comparisons.
- A separate evaluation was made to perceive a dependency between CoStatus volumetric variables and stroke volume index (SVI), which was accomplished by performing a linear regression analysis and calculating the r(2) coefficient of determination.
Study Findings
- The study revealed significant changes in TEDVI and ACVI during the HEMO and RESU statuses.
- The administration of NE resulted in pronounced changes in MAP and CVP, but did not affect TEDVI and ACVI.
- CBVI stood out due to its high inconsistency and variability in identifying the volume status.
- Correlation analysis showed that TEDVI consistently correlated with SVI and volume-induced changes in SVI.
Conclusions
- The study concluded that in the given animal model, TEDVI and ACVI perform better than CBVI in consistently indicating hemorrhage.
- It was also observed that TEDVI – but neither ACVI nor CBVI – correlated with volume-induced changes in SVI.
- The administration of NE did not impact this correlation.
Cite This Article
APA
Vigani A, Shih A, Queiroz P, Pariaut R, Gabrielli A, Thuramalla N, Bandt C.
(2012).
Quantitative response of volumetric variables measured by a new ultrasound dilution method in a juvenile model of hemorrhagic shock and resuscitation.
Resuscitation, 83(8), 1031-1037.
https://doi.org/10.1016/j.resuscitation.2012.01.014 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
MeSH Terms
- Animals
- Arterial Pressure
- Blood Volume / drug effects
- Blood Volume / physiology
- Disease Models, Animal
- Fluid Therapy / methods
- Hemodynamics
- Horses
- Norepinephrine / pharmacology
- Resuscitation / methods
- Shock, Hemorrhagic / physiopathology
- Shock, Hemorrhagic / therapy
- Ultrasonography
Citations
This article has been cited 3 times.- Hopster K, Hurcombe SDA. Agreement of Bioreactance Cardiac Output Monitoring With Thermodilution in Healthy Standing Horses. Front Vet Sci 2021;8:701339.
- Saxena R, Durward A, Steeley S, Murdoch IA, Tibby SM. Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility. Intensive Care Med 2015 Dec;41(12):2161-9.
- Vrancken SL, van Heijst AF, Hopman JC, Liem KD, van der Hoeven JG, de Boode WP. Hemodynamic volumetry using transpulmonary ultrasound dilution (TPUD) technology in a neonatal animal model. J Clin Monit Comput 2015 Oct;29(5):643-52.
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