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- W2313766095 abstract "Introduction: Cardiac output (CO), venous oxygenation (SvO2), and arterial blood pressure decrease during hemorrhage, and are proportional to blood volume lost. However, these invasive metrics are not available early in care. Standard noninvasive continuous vital signs of heart rate and pulse oxygen saturation (SpO2) have little or no predictive value during hypovolemia. On the other-hand, non-invasive Near-infrared spectroscopy (NIRS) of cerebral tissue oxygenation saturation (ScrO2) has been found to reproducibly decrease during hemorrhage. However, compared to invasively measured variables, the decrease in ScrO2 is delayed by 3–9 minutes (min). Studies have shown that heart and brain are favored in the redistribution of CO during hemorrhage at the expense of skin, muscle, and splanchnic organs. Methods: Propofol-anesthetized swine underwent a 5–7 hour regimen of hemorrhage and resuscitation. The model is representative of critical care monitoring for supportive therapy of fluid and vasopressors to treat hypovolemia. Data collection for this analysis began after achieving a stable 30–60 min baseline period, in which Mean Arterial Pressure (MAP) > 70 mmHg, and SvO2 > 70%. Hemorrhage was performed at 1 ml/kg/min. Measured variables include MAP, CO, mixed and central venous oxygenation. ScrO2 and SmO2 were measured by NIRS (Nonin Equanox 7600). Results: ScrO2 and SmO2 decreased similarly throughout hemorrhage with comparable delays of 4–10 min relative to invasive measurements. Observed values were normalized to baseline (mean ± SD). At 5, 10, and 15 min of hemorrhage, MAP: 79% ± 17.7, 65% ± 22.9, and 53% ± 23.1; ScrO2: 97% ± 5.0, 88% ± 7.6, and 80% ± 8.4; SmO2: 92% ± 9.6, 86% ± 12.4, and 83% ± 21.0. Conclusions: Our data did not support our hypothesis. Although, ScrO2 and SmO2 decreased at similar time rates during hemorrhage, there was a significant time delay in non-invasively measured tissue oxygenation compared to invasive continuous variables of CO, MAP, and SvO2. The NIRS trend analysis, however, offers promise as an assessment of developing hypovolemia when only intermittent vital signs monitoring is available." @default.
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- W2313766095 date "2013-12-01" @default.
- W2313766095 modified "2023-09-27" @default.
- W2313766095 title "308" @default.
- W2313766095 doi "https://doi.org/10.1097/01.ccm.0000439452.26600.81" @default.
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