Detection of volume loss using the Nexfin device in blood donors
Detection of volume loss using the Nexfin device in blood donors
复制标题
使用 Nexfin 装置检测献血者的血容量损失
作者：
S. Nicia;T. A. Veelen;J. Stens;M. Koopman;C. Boer
我们研究了 Nexfin 无创连续动脉血压测量得出的哪些血流动力学参数最适合检测自主呼吸受试者的受控容量损失。对 40 名全血捐献者进行了血流动力学监测。记录受控呼吸期间的平均动脉压、心脏指数、全身血管阻力指数和脉压变化，并在献血前后进行瓦氏动作。献血导致心脏指数下降（从 3.96 ± 0.84 l.min−1.m2 至 3.30 ± 0.61 l.min−1.m2；p < 0.001），全身血管阻力增加（从 1811 ± 450 dyn.s.cm−5.m2 至 2137 ± 428 dyn.s.cm−5.m2；p < 0.001）和脉压变化增加（从 13.4 ± 5.1 到 15.3 ± 5.4%；p = 0.02）。用于检测容量损失的受试者工作特征曲线下面积对于心脏指数（0.94，95% CI 0.88-0.99）和全身血管阻力（0.90，95% CI 0.82-0.99）最高。 Nexfin 是一种无创血流动力学监测仪，可以检测自主呼吸受试者的血容量变化。
We investigated which haemodynamic parameters derived from Nexfin non‐invasive continuous arterial blood pressure measurements are optimal to detect controlled volume loss in spontaneously breathing subjects. Haemodynamic monitoring was performed in 40 whole‐blood donors. Mean arterial pressure, cardiac index, systemic vascular resistance index and pulse pressure variation were recorded during controlled breathing, and a Valsalva manoeuvre was performed before and after blood donation. Blood donation resulted in a reduction in cardiac index (from 3.96 ± 0.84 l.min−1.m2 to 3.30 ± 0.61 l.min−1.m2; p < 0.001), an increase in systemic vascular resistance (from 1811 ± 450 dyn.s.cm−5.m2 to 2137 ± 428 dyn.s.cm−5.m2; p < 0.001) and an increase in pulse pressure variation (from 13.4 ± 5.1 to 15.3 ± 5.4%; p = 0.02). The area under the receiver operating characteristic curve to detect volume loss was highest for cardiac index (0.94, 95% CI 0.88–0.99) and systemic vascular resistance (0.90, 95% CI 0.82–0.99). Nexfin is a non‐invasive haemodynamic monitor that can feasibly detect volaemic changes in spontaneously breathing subjects.