title: Perioperative monitoring of circulating and central blood volume in cardiac surgery by pulse dye densitometry.
abstract: OBJECTIVE
  To determine perioperative changes in circulating (BVI) and central blood volume (CBVI) by a new dye dilution technique using pulse dye densitometry.
  
  
  METHODS
  Prospective observational study in the cardiac anesthesia and intensive care unit of a university hospital.
  
  
  METHODS
  Sixty-six patients undergoing coronary artery bypass surgery.
  
  
  RESULTS
  Hemodynamic measurements by the dye dilution method using pulse dye densitometry were performed prior to skin incision and 3.3+/-1.4 h and 17+/-2.7 h after surgery. Based on conventional monitoring the therapeutic goals of hemodynamic therapy were achieved in all of the patients of this study. Despite a marked positive fluid balance which developed during surgery mean BVI decreased significantly after surgery while CBVI remained unchanged. Postoperative BVI deficits vs. preoperative values were observed in 78% of patients; these BVI deficits were profound in 29% of the cases. In contrast, 65% of the individual patients showed no or only minor postoperative changes in CBVI vs. preoperative values.
  
  
  CONCLUSIONS
  Changes in the intravascular volume compartments affected BVI to a greater extent than CBVI. Therefore measuring circulating in addition to central blood volume may be useful to ensure a normal circulating blood volume that can compensate for any change in the central vascular compartment.
authors.affiliation: Department of Anesthesiology, Friedrich Alexander University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany. frank.bremer@kfa.imed.uni-erlangen.de
authors.forename: Frank
authors.initials: F
authors.lastname: Bremer
authors.forename: Albert
authors.initials: A
authors.lastname: Schiele
authors.forename: Jan
authors.initials: J
authors.lastname: Sagkob
authors.forename: Thomas
authors.initials: T
authors.lastname: Palmaers
authors.forename: Klaus
authors.initials: K
authors.lastname: Tschaikowsky
mesh_terms: D000704:Analysis of Variance; D001811:Blood Volume Determination / Q000379:methods*; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D003720:Densitometry / Q000379:methods*; D004395:Dye Dilution Technique; D006439:Hemodynamics; D006801:Humans; D007208:Indocyanine Green; D019990:Perioperative Care; D019095:Point-of-Care Systems; D011446:Prospective Studies
chemical_list: D007208:Indocyanine Green