Cargando…
The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model
BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHO...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219587/ https://www.ncbi.nlm.nih.gov/pubmed/28070330 http://dx.doi.org/10.1016/j.amsu.2016.12.052 |
_version_ | 1782492480454787072 |
---|---|
author | Nadler, Roy Glassberg, Elon Gabbay, Itay E. Wagnert-Avraham, Linn Yaniv, Gal Kushnir, David Eisenkraft, Arik Bobrovsky, Ben-Zion Gabbay, Uri |
author_facet | Nadler, Roy Glassberg, Elon Gabbay, Itay E. Wagnert-Avraham, Linn Yaniv, Gal Kushnir, David Eisenkraft, Arik Bobrovsky, Ben-Zion Gabbay, Uri |
author_sort | Nadler, Roy |
collection | PubMed |
description | BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHODS: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls. We calculated the approximated CVRI (CVRI(A)). The course of haemodynamic deterioration was defined according to the cumulative blood loss until shock. The ability of heart rate (HR), mean arterial blood pressure (MABP), stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) and the CVRI(A) to predict haemodynamic deterioration was evaluated according to three criteria: strength of association with the course of haemodynamic deterioration (r(2) > 0.5); threshold for haemodynamic deterioration detection; and range at which the parameter remained consistently monotonous course of deterioration. RESULTS: Three parameters met the first criterion for prediction of haemodynamic deterioration: HR (r(2) = 0.59), SV (r(2) = 0.57) and CVRI(A) (r(2) = 0.66). Results were negative for MABP (r(2) = 0.27), CO (r(2) = 0.33) and SVR (r(2) = 0.02). The detection threshold of the CVRI(A) was 200–300 ml blood loss whereas HR, SV and CO showed a delay in detection, MABP and CVRI exhibited a wide indicative range toward shock. CONCLUSIONS: The CVRI(A) met preset criteria of a potential predictor of haemorrhage-related haemodynamic deterioration. Prospective studies are required to evaluate use of the CVRI in combat medicine. LEVEL OF EVIDENCE: Level III. |
format | Online Article Text |
id | pubmed-5219587 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-52195872017-01-09 The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model Nadler, Roy Glassberg, Elon Gabbay, Itay E. Wagnert-Avraham, Linn Yaniv, Gal Kushnir, David Eisenkraft, Arik Bobrovsky, Ben-Zion Gabbay, Uri Ann Med Surg (Lond) Original Research BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHODS: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls. We calculated the approximated CVRI (CVRI(A)). The course of haemodynamic deterioration was defined according to the cumulative blood loss until shock. The ability of heart rate (HR), mean arterial blood pressure (MABP), stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) and the CVRI(A) to predict haemodynamic deterioration was evaluated according to three criteria: strength of association with the course of haemodynamic deterioration (r(2) > 0.5); threshold for haemodynamic deterioration detection; and range at which the parameter remained consistently monotonous course of deterioration. RESULTS: Three parameters met the first criterion for prediction of haemodynamic deterioration: HR (r(2) = 0.59), SV (r(2) = 0.57) and CVRI(A) (r(2) = 0.66). Results were negative for MABP (r(2) = 0.27), CO (r(2) = 0.33) and SVR (r(2) = 0.02). The detection threshold of the CVRI(A) was 200–300 ml blood loss whereas HR, SV and CO showed a delay in detection, MABP and CVRI exhibited a wide indicative range toward shock. CONCLUSIONS: The CVRI(A) met preset criteria of a potential predictor of haemorrhage-related haemodynamic deterioration. Prospective studies are required to evaluate use of the CVRI in combat medicine. LEVEL OF EVIDENCE: Level III. Elsevier 2016-12-29 /pmc/articles/PMC5219587/ /pubmed/28070330 http://dx.doi.org/10.1016/j.amsu.2016.12.052 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Nadler, Roy Glassberg, Elon Gabbay, Itay E. Wagnert-Avraham, Linn Yaniv, Gal Kushnir, David Eisenkraft, Arik Bobrovsky, Ben-Zion Gabbay, Uri The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model |
title | The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model |
title_full | The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model |
title_fullStr | The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model |
title_full_unstemmed | The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model |
title_short | The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model |
title_sort | approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: a swine exsanguination model |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219587/ https://www.ncbi.nlm.nih.gov/pubmed/28070330 http://dx.doi.org/10.1016/j.amsu.2016.12.052 |
work_keys_str_mv | AT nadlerroy theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT glassbergelon theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT gabbayitaye theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT wagnertavrahamlinn theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT yanivgal theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT kushnirdavid theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT eisenkraftarik theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT bobrovskybenzion theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT gabbayuri theapproximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT nadlerroy approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT glassbergelon approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT gabbayitaye approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT wagnertavrahamlinn approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT yanivgal approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT kushnirdavid approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT eisenkraftarik approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT bobrovskybenzion approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel AT gabbayuri approximatedcardiovascularreserveindexcomplieswithhaemorrhagerelatedhemodynamicdeteriorationpatternaswineexsanguinationmodel |