手指光敏血流图检测代偿期献血者的早期急性失血:一项试点研究。

IF 2.3 4区 医学 Q3 BIOPHYSICS
Gerardo Speroni, Patricia Antedoro, Silvia Marturet, Gabriela Martino, Celia Chavez, Cristian Hidalgo, María V Villacorta, Ivo Ahrtz, Manuel Casadei, Nora Fuentes, Peter Kremeier, Stephan H Böhm, Gerardo Tusman
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引用次数: 0

摘要

目的:由于生命体征通常正常,而且患者在早期阶段仍无症状,因此诊断初发急性低血容量症具有挑战性。如果医生能够及早治疗,早期发现这种情况将影响患者的预后。因此,开发一种无创、连续的床旁监测工具,在患者血流动力学不稳定之前检测出隐性低血容量,具有重要的临床意义。我们假设脉搏血氧仪红外光的交替(AC)和连续(DC)分量对患者血容量的急性微小变化非常敏感。我们的目的是在健康献血者群体中测试这一假设,将其作为轻微低血容量模型:我们计划对献血志愿者进行前瞻性研究,让他们在仰卧姿势下抽取 450 毫升血液。记录无创动脉血压、心率和手指脉搏氧饱和度。对献血前、献血后以及通过被动抬腿动作进行自动输血时的数据进行分析:主要结果:66 名志愿者(44% 为女性)成功完成了方案。没有出现低血容量、动脉低血压(收缩压 100 次/分)或低氧血症(SpO2
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Finger photopletysmography detects early acute blood loss in compensated blood donors: a pilot study.

Objective.Diagnosis of incipient acute hypovolemia is challenging as vital signs are typically normal and patients remain asymptomatic at early stages. The early identification of this entity would affect patients' outcome if physicians were able to treat it precociously. Thus, the development of a noninvasive, continuous bedside monitoring tool to detect occult hypovolemia before patients become hemodynamically unstable is clinically relevant. We hypothesize that pulse oximeter's alternant (AC) and continuous (DC) components of the infrared light are sensitive to acute and small changes in patient's volemia. We aimed to test this hypothesis in a cohort of healthy blood donors as a model of slight hypovolemia.Approach.We planned to prospectively study blood donor volunteers removing 450 ml of blood in supine position. Noninvasive arterial blood pressure, heart rate, and finger pulse oximetry were recorded. Data was analyzed before donation, after donation and during blood auto-transfusion generated by the passive leg-rising (PLR) maneuver.Main results.Sixty-six volunteers (44% women) accomplished the protocol successfully. No clinical symptoms of hypovolemia, arterial hypotension (systolic pressure < 90 mmHg), brady-tachycardia (heart rate <60 and >100 beats-per-minute) or hypoxemia (SpO2< 90%) were observed during donation. The AC signal before donation (median 0.21 and interquartile range 0.17 a.u.) increased after donation [0.26(0.19) a.u;p< 0.001]. The DC signal before donation [94.05(3.63) a.u] increased after blood extraction [94.65(3.49) a.u;p< 0.001]. When the legs' blood was auto-transfused during the PLR, the AC [0.21(0.13) a.u.;p= 0.54] and the DC [94.25(3.94) a.u.;p= 0.19] returned to pre-donation levels.Significance.The AC and DC components of finger pulse oximetry changed during blood donation in asymptomatic volunteers. The continuous monitoring of these signals could be helpful in detecting occult acute hypovolemia. New pulse oximeters should be developed combining the AC/DC signals with a functional hemodynamic monitoring of fluid responsiveness to define which patient needs fluid administration.

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来源期刊
Physiological measurement
Physiological measurement 生物-工程:生物医学
CiteScore
5.50
自引率
9.40%
发文量
124
审稿时长
3 months
期刊介绍: Physiological Measurement publishes papers about the quantitative assessment and visualization of physiological function in clinical research and practice, with an emphasis on the development of new methods of measurement and their validation. Papers are published on topics including: applied physiology in illness and health electrical bioimpedance, optical and acoustic measurement techniques advanced methods of time series and other data analysis biomedical and clinical engineering in-patient and ambulatory monitoring point-of-care technologies novel clinical measurements of cardiovascular, neurological, and musculoskeletal systems. measurements in molecular, cellular and organ physiology and electrophysiology physiological modeling and simulation novel biomedical sensors, instruments, devices and systems measurement standards and guidelines.
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