Advertisement

 

 

The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model.

The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model.
Author Information (click to view)

Nadler R, Glassberg E, Gabbay IE, Wagnert-Avraham L, Yaniv G, Kushnir D, Eisenkraft A, Bobrovsky BZ, Gabbay U,


Nadler R, Glassberg E, Gabbay IE, Wagnert-Avraham L, Yaniv G, Kushnir D, Eisenkraft A, Bobrovsky BZ, Gabbay U, (click to view)

Nadler R, Glassberg E, Gabbay IE, Wagnert-Avraham L, Yaniv G, Kushnir D, Eisenkraft A, Bobrovsky BZ, Gabbay U,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Annals of medicine and surgery (2012) 2016 12 2914() 1-7 doi 10.1016/j.amsu.2016.12.052
Abstract
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 (CVRIA). 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 CVRIA 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 CVRIA (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 CVRIA 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 CVRIA 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.

Submit a Comment

Your email address will not be published. Required fields are marked *

four × two =

[ HIDE/SHOW ]