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...

Descripción completa

Detalles Bibliográficos
Autores principales: Nadler, Roy, Glassberg, Elon, Gabbay, Itay E., Wagnert-Avraham, Linn, Yaniv, Gal, Kushnir, David, Eisenkraft, Arik, Bobrovsky, Ben-Zion, Gabbay, Uri
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