This study confirmed the theoretical framework of right ventricular preload and ventricular filling pressure and respiratory variation of stroke volume. The result also suggests that SVV can correctly predict preload status compared to pressure-based indices.

No abstract

HES 70/0.5 exerted larger volume effects than did crystalloid under nonspecific conditions. However, similar volume effects were observed during volume loss and extensive sympathetic blockade.

Oscillometric determination of blood pressure may be advantageous, as cuff inflation requires lower cuff pressure and shorter duration than deflation. In this observational study, we compared the blood pressure value, cuff pressure, and duration of cuff inflation between a prototype of inflationary non-invasive blood pressure (NIBP) and conventional deflationary NIBP in adult patients during anesthesia. Three hundred and twenty-three pairs of measurements were obtained from 64 subjects. The bias and precision of systolic pressure and diastolic pressure were 2.9 ± 8.3 and 5.6 ± 6.1 mmHg, respectively. Inflationary NIBP could better determine NIBP with lower cuff pressure than deflationary NIBP (124 ± 22 vs. 160 ± 33 mmHg, p < 0.05). Inflationary NIBP could also determine NIBP more quickly (13.0 ± 2.3 vs. 32.7 ± 13.6 s, p < 0.05). These data suggest that inflationary NIBP may reduce cuff-related discomfort and complications, and has reasonable accuracy compared to deflationary NIBP in adult surgical patients.

The purpose of this prospective study was to evaluate the accuracy and trending ability of a four-wavelength pulse-total hemoglobinometer that continuously and noninvasively measures hemoglobin in surgical patients. With IRB approval and informed consent, spectrophotometric hemoglobin (SpHb) was measured with a pulse-total hemoglobinometer manufactured by Nihon Kohden Corp (Tokyo, Japan) and compared to the CO-oximeter equipped with blood gas analyzer. Two hundred twenty-five samples from 56 subjects underwent analysis. Bland-Altman analysis revealed that the bias ± precision of the current technology was 0.0 ± 1.4 g/dl and -0.2 ± 1.3 g/dl for total samples and samples with 8 < Hb < 11 g/dl, respectively. The percentages of samples with intermediate risk of therapeutic error in error grid analysis and the concordance rate of 4-quadrant trending assay was 17 % and 77 %, respectively. The Cohen kappa statistic for Hb < 10 g/dl was 0.38, suggesting that the agreement between SpHb and CO-oximeter-derived Hb was fair. Collectively, wide limits of agreement, especially at the critical level of hemoglobin, and less than moderate agreement against CO-oximeter-derived hemoglobin preclude the use of the pulse-total hemoglobinometer as a decision-making tool for transfusion.