Venous Waveform Analysis to Predict Volume Overload

项目总结 在围手术期环境中，精确控制血管内容量状态是重要的。它 已证明围手术期的容量超负荷和复苏中 这段时间会增加发病率、死亡率、住院时间和围手术期护理费用。 不幸的是，临床症状和目前的监测策略在提供 准确、实时地评估卷状态。这项提议将发展一种 独特的生理信号，无创静脉波形分析(NIVA)，用于监测 出血和容量超负荷的血管内容量状态。中的概念验证数据 人类和实验动物模型表明，NIVA提供了一个可靠的迹象 血管内容量状况，支持这一提议的前提。此提案将使用 猪控制性失血、复苏和容量超负荷的实验模型 复苏以验证和改进波形分析算法。NIVA将在中国接受测试 进一步的猪研究和人体大隐静脉在体外血流循环中的研究 模拟细胞外基质作为受控模型系统以确定局限性和 NIVA的作用机制。这些研究将被用来降低与使用 NIVA和将导致更好地理解静脉波形分析(用于精确 血管内容量的管理)和静脉血流动力学(主要在研究中的 心血管系统的一部分)。

PROJECT SUMMARY In the perioperative environment, precise control of intravascular volume status is important. It has been demonstrated that both volume overload and under resuscitation in the perioperative period can increase morbidity, mortality, length of stay, and cost of perioperative care. Unfortunately, clinical signs and current monitoring strategies are unreliable in providing accurate, real time assessments of volume status. This proposal will develop the use of a unique physiologic signal, Non-Invasive Venous waveform Analysis (NIVA), for monitoring intravascular volume status of both hemorrhage and volume overload. Proof of concept data in humans and experimental animal models, demonstrate that NIVA provides a reliable indication of intravascular volume status, supporting the premise of this proposal. This proposal will use an experimental porcine model of controlled hemorrhage, resuscitation, and volume overload resuscitation to validate and refine an algorithm for waveform analysis. NIVA will be tested in further porcine studies and bench-top human saphenous veins in an ex vivo flow loop with a simulated extracellular matrix as a controlled model system to determine limitations and mechanisms of NIVA. These studies will be used to mitigate risks associated with the use of NIVA and will lead to a better understanding of venous waveform analysis (for precise management of intravascular volume) and of venous hemodynamics (a largely under studied part of the cardiovascular system).