Central cardiovascular and oxygen variables during haemorrhage in the pig.
BACKGROUND
We evaluated the ability of the standards issued by the Danish Society of Anaesthesiologists to reflect a blood loss.


METHODS
In 9 pigs bled (0-24 ml kg-1 and retransfused (to 28 ml kg-1) during halothane anaesthesia central cardiovascular, thoracic electrical impedance (TI), oxygen, acid-base and temperature variables were recorded.


RESULTS
With the recommendation for minor surgery (mean arterial pressure (MAP) and heart rate (HR)), the correlation to the blood loss was 0.74 (P < 0.001) and with that for major surgery (MAP, HR, central venous pressure (CVP) and rectal temperature (Tempr)) it was 0.79 (P < 0.001). With the recommendation for extensive surgery (MAP, HR, CVP, pulmonary artery catheter variables and the central-peripheral temperature difference (delta Tempr-t)), the correlation was 0.84 (P < 0.001). Non-invasive monitoring (MAP, HR, delta Tempr-t, TI and near-infrared spectroscopy of the brain (SinvosO2)) was only slightly better than basal monitoring (r = 0.76, P < 0.001). However, adding arterial base excess (BE), TI, and peripheral temperature (Tempt) to the recommendation for major surgery resulted in a correlation of 0.87 (P < 0.001), while adding BE and TI to the recommendation for extensive surgery raised correlation to only 0.88 (P < 0.001).


CONCLUSIONS
When the recommendations were followed the correlation to the blood loss ranged from 0.74-0.84. However, with the recording of MAP, HR, CVP, delta Tempr-t, BE and TI a correlation of 0.87 was achieved, indicating that a pulmonary artery catheter may not be in need for patients undergoing surgical procedures with expected haemorrhage.
Krantz
T
T
Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
Sztuk
F
F
Swiatek
F
F
Jacobsen
J
J
Secher
N H
NH
D000818:Animals; D005260:Female; D006439:Hemodynamics; D006470:Hemorrhage / Q000503:physiopathology*; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D013552:Swine
D010100:Oxygen