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
{"title":"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。","authors":"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","doi":"10.1088/1361-6579/ad4c54","DOIUrl":null,"url":null,"abstract":"<p><p><i>Objective.</i>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.<i>Approach.</i>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.<i>Main results.</i>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 (SpO<sub>2</sub>< 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;<i>p</i>< 0.001]. The DC signal before donation [94.05(3.63) a.u] increased after blood extraction [94.65(3.49) a.u;<i>p</i>< 0.001]. When the legs' blood was auto-transfused during the PLR, the AC [0.21(0.13) a.u.;<i>p</i>= 0.54] and the DC [94.25(3.94) a.u.;<i>p</i>= 0.19] returned to pre-donation levels.<i>Significance.</i>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.</p>","PeriodicalId":20047,"journal":{"name":"Physiological measurement","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Finger photopletysmography detects early acute blood loss in compensated blood donors: a pilot study.\",\"authors\":\"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\",\"doi\":\"10.1088/1361-6579/ad4c54\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Objective.</i>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.<i>Approach.</i>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.<i>Main results.</i>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 (SpO<sub>2</sub>< 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;<i>p</i>< 0.001]. The DC signal before donation [94.05(3.63) a.u] increased after blood extraction [94.65(3.49) a.u;<i>p</i>< 0.001]. When the legs' blood was auto-transfused during the PLR, the AC [0.21(0.13) a.u.;<i>p</i>= 0.54] and the DC [94.25(3.94) a.u.;<i>p</i>= 0.19] returned to pre-donation levels.<i>Significance.</i>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.</p>\",\"PeriodicalId\":20047,\"journal\":{\"name\":\"Physiological measurement\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-05-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physiological measurement\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1088/1361-6579/ad4c54\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"BIOPHYSICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiological measurement","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1088/1361-6579/ad4c54","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BIOPHYSICS","Score":null,"Total":0}
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.
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.