Evaluation of the utility of the Vigileo FloTrac™, LiDCO™, USCOM and CardioQ™to detect hypovolaemia in conscious volunteers: a proof of concept study

O’Loughlin, Edmond; Ward, Mandy; Crossley, Anne; Hughes, Ryan; Bremner, Alexandra; Corcoran, Tomás

doi:10.1111/anae.12949

Cited by 23 publications

(20 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The haemodynamic parameter with the highest predictive value was the FloTrac stroke volume, followed by the CardioQ volume [15]. However, the ROC AUCs for both indices remained below 0.85, albeit higher than the predictive value of heart rate and blood pressure [15]. In our study, CI and SVRI were highly predictive for a volume loss of 500 ml.…”

Section: Discussioncontrasting

confidence: 55%

“…Others recently showed the predictive value to detect more than 10% blood loss in eight volunteers, which reflected on estimation a volume of about 500 ml. The haemodynamic parameter with the highest predictive value was the FloTrac stroke volume, followed by the CardioQ volume [15]. However, the ROC AUCs for both indices remained below 0.85, albeit higher than the predictive value of heart rate and blood pressure [15].…”

Section: Discussionmentioning

confidence: 87%

“…In contrast, the Nexfin dynamic elastance based on the PPV/SVV ratio adequately predicted the arterial pressure response to a fluid bolus in spontaneously breathing patients without forced breathing manoeuvres [13]. To avoid the influence of breathing artefacts on haemodynamic indices, others investigated the ability to detect a volume shift in conscious volunteers using PPV [14], cardiac output [15] or stroke volume [16]. O'Loughlin reported that cardiac output values derived from minimally invasive haemodynamic devices adequately reflected at best a 2.5% estimated blood volume loss in normally breathing volunteers [15].…”

Section: Introductionmentioning

confidence: 99%

“…To avoid the influence of breathing artefacts on haemodynamic indices, others investigated the ability to detect a volume shift in conscious volunteers using PPV [14], cardiac output [15] or stroke volume [16]. O'Loughlin reported that cardiac output values derived from minimally invasive haemodynamic devices adequately reflected at best a 2.5% estimated blood volume loss in normally breathing volunteers [15]. The optimal haemodynamic indicator for fluid shifts in spontaneously breathing subjects is still debated.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Detection of volume loss using the Nexfin device in blood donors

et al. 2015

View full text Add to dashboard Cite

SummaryWe investigated which haemodynamic parameters derived from Nexfin non-invasive continuous arterial blood pressure measurements are optimal to detect controlled volume loss in spontaneously breathing subjects. Haemodynamic monitoring was performed in 40 whole-blood donors. Mean arterial pressure, cardiac index, systemic vascular resistance index and pulse pressure variation were recorded during controlled breathing, and a Valsalva manoeuvre was performed before and after blood donation. Blood donation resulted in a reduction in cardiac index (from 3.96 AE 0.84 l.min .m 2 ; p < 0.001) and an increase in pulse pressure variation (from 13.4 AE 5.1 to 15.3 AE 5.4%; p = 0.02). The area under the receiver operating characteristic curve to detect volume loss was highest for cardiac index (0.94, 95% CI 0.88-0.99) and systemic vascular resistance (0.90, 95% CI 0.82-0.99). Nexfin is a non-invasive haemodynamic monitor that can feasibly detect volaemic changes in spontaneously breathing subjects.

show abstract

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detection of volume loss using the Nexfin device in blood donors

et al. 2015

View full text Add to dashboard Cite

show abstract

“…However, the latter is still first line practice in many UK EDs, and was therefore selected as the method of choice in this study. Although SSAD is reported to reliably detect a 7.5% blood volume loss in healthy volunteers few studies have investigated its accuracy to detect fluid responsiveness [64,65]. A meta-analysis on SSAD accuracy in mechanically ventilated patients by Chong and Peyton found an overall cardiac output percentage error of 42.7% (95% CI: 38.5-46.9%) in comparison to PAC [66].…”

Section: Discussionmentioning

confidence: 99%

Emergency department non-invasive cardiac output study (EDNICO): an accuracy study

McGregor

Sharma

Gupta

et al. 2020

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background: There is little published data investigating non-invasive cardiac output monitoring in the emergency department (ED). We assess here the accuracy of five non-invasive methods in detecting fluid responsiveness in the ED: (1) common carotid artery blood flow, (2) suprasternal aortic Doppler, (3) bioreactance, (4) plethysmography with digital vascular unloading method, and (5) inferior vena cava collapsibility index. Left ventricular outflow tract echocardiography derived velocity time integral is the reference standard. This follows an assessment of feasibility and repeatability of these methods in the same cohort of ED patients. Methods: This is a prospective observational study of non-invasive methods for assessing fluid responsiveness in the ED. Participants were non-ventilated ED adult patients requiring intravenous fluid resuscitation. Sensitivity and specificity of each method in determining the fluid responsiveness status of participants is determined in comparison to the reference standard. Results: Thirty-three patient data sets were included for analysis. The specificity and sensitivity to detect fluid responders was 46.2 and 45% for common carotid artery blood flow (CCABF), 61.5 and 63.2% for suprasternal artery Doppler (SSAD), 46.2 and 50% for bioreactance, 50 and 41.2% for plethysmography vascular unloading technique (PVUT), and 63.6 and 47.4% for inferior vena cava collapsibility index (IVCCI), respectively. Analysis of agreement with Cohen's Kappa − 0.08 for CCABF, 0.24 for SSAD, − 0.04 for bioreactance, − 0.08 for PVUT, and 0.1 for IVCCI. Conclusion: In this study, non-invasive methods were not found to reliably identify fluid responders. Non-invasive methods of identifying fluid responders are likely to play a key role in improving patient outcome in the ED in fluid depleted states such as sepsis. These results have implications for future studies assessing the accuracy of such methods.

show abstract

Predictive values of pulse pressure variation and stroke volume variation for fluid responsiveness in patients with pneumoperitoneum

Zlicar

Novak-Jankovič

Blagus

et al. 2017

J Clin Monit Comput

View full text Add to dashboard Cite

Animal studies suggest that dynamic predictors remain useful in patients with pneumoperitoneum, but human data is conflicting. Our aim was to determine predictive values of pulse pressure variation (PPV) and stroke volume variation (SVV) in patients with pneumoperitoneum using LiDCORapid™ haemodynamic monitor. Standardised fluid challenges of colloid were administered to patients undergoing laparoscopic procedures, one fluid challenge per patient. Intra-abdominal pressure was automatically held at 12 mmHg. Fluid responsiveness was defined as an increase in nominal stroke index (nSI) ≥ 10%. Linear regression was used to assess the ability of PPV and SVV to track the changes of nSI and logistic regression and area under the receiver operating curve (AUROC) to assess the predictive value of PPV and SVV for fluid responsiveness. Threshold values for PPV and SVV were obtained using the "gray zone" approach. A p < 0.05 was considered as statistically significant. 56 patients were included in analysis. 41 patients (73%) responded to fluids. Both PPV and SVV tracked changes in nSI (Spearman correlation coefficients 0.34 for PPV and 0.53 for SVV). Odds ratio for fluid responsiveness for PPV was 1.163 (95% CI 1.01-1.34) and for SVV 1.341 (95% CI 1.10-1.63). PPV achieved an AUROC of 0.674 (95% CI 0.518-0.830) and SVV 0.80 (95% CI 0.668-0.932). The gray zone of PPV ranged between 6.5 and 20.5% and that of SVV between 7.5 and 13%. During pneumoperitoneum, as measured by LiDCORapid™, PPV and SVV can predict fluid responsiveness, however their sensitivity is lower than the one reported in conditions without pneumoperitoneum. Trial registry number: (with the Australian New Zealand Clinical Trials Registry): ACTRN12612000456853.

show abstract

Evaluation of the utility of the Vigileo FloTrac^™, LiDCO^™, USCOM and CardioQ^™to detect hypovolaemia in conscious volunteers: a proof of concept study

Cited by 23 publications

References 24 publications

Detection of volume loss using the Nexfin device in blood donors

Detection of volume loss using the Nexfin device in blood donors

Emergency department non-invasive cardiac output study (EDNICO): an accuracy study

Predictive values of pulse pressure variation and stroke volume variation for fluid responsiveness in patients with pneumoperitoneum

Contact Info

Product

Resources

About