title: Evaluation of the utility of the Vigileo FloTrac(™) , LiDCO(™) , USCOM and CardioQ(™) to detect hypovolaemia in conscious volunteers: a proof of concept study.
abstract: It is important to detect and treat hypovolaemia; however, detection is particularly challenging in the conscious, spontaneously breathing patient. Eight healthy male volunteers were monitored using four minimally invasive monitors: Vigileo FloTrac(™) ; LiDCOrapid(™) ; USCOM 1A; and CardioQ(™) oesophageal Doppler. Monitor output and clinical signs were recorded during incremental venesection of 2.5% estimated blood volume aliquots to a total of 20% blood volume removed. A statistically significant difference from baseline stroke volume was detected after 2.5% blood loss using the LiDCO (p = 0.007), 7.5% blood loss using the USCOM (p = 0.019), and 12.5% blood loss using the CardioQ (p = 0.046) and the FloTrac (p = 0.028). Receiver operator characteristic curves for predicting > 10% blood loss had areas under the curve of 0.68-0.82. The minimally invasive cardiac output devices tested can detect blood loss by a reduction in stroke volume in awake volunteers, and may have a role in guiding fluid replacement in conscious patients with suspected hypovolaemia.
authors.affiliation: Department of Anaesthesia, Fremantle Hospital, Perth, Western Australia, Australia; School of Medicine and Pharmacology, Perth, Western Australia, Australia.
authors.forename: E
authors.initials: E
authors.lastname: O'Loughlin
authors.forename: M
authors.initials: M
authors.lastname: Ward
authors.forename: A
authors.initials: A
authors.lastname: Crossley
authors.forename: R
authors.initials: R
authors.lastname: Hughes
authors.forename: A P
authors.initials: AP
authors.lastname: Bremner
authors.forename: T
authors.initials: T
authors.lastname: Corcoran
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology*; D003243:Consciousness / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods; D004867:Equipment Design; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology*; D013815:Thermodilution / Q000379:methods