title: Detection of volume loss using the Nexfin device in blood donors.
abstract: We investigated which haemodynamic parameters derived from Nexfin non-invasive continuous arterial blood pressure measurements are optimal to detect controlled volume loss in spontaneously breathing subjects. Haemodynamic monitoring was performed in 40 whole-blood donors. Mean arterial pressure, cardiac index, systemic vascular resistance index and pulse pressure variation were recorded during controlled breathing, and a Valsalva manoeuvre was performed before and after blood donation. Blood donation resulted in a reduction in cardiac index (from 3.96 ± 0.84 l.min(-1) .m(2) to 3.30 ± 0.61 l.min(-1) .m(2) ; p < 0.001), an increase in systemic vascular resistance (from 1811 ± 450 dyn.s.cm(-5) .m(2) to 2137 ± 428 dyn.s.cm(-5) .m(2) ; p < 0.001) and an increase in pulse pressure variation (from 13.4 ± 5.1 to 15.3 ± 5.4%; p = 0.02). The area under the receiver operating characteristic curve to detect volume loss was highest for cardiac index (0.94, 95% CI 0.88-0.99) and systemic vascular resistance (0.90, 95% CI 0.82-0.99). Nexfin is a non-invasive haemodynamic monitor that can feasibly detect volaemic changes in spontaneously breathing subjects.
authors.affiliation: VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: S B
authors.initials: SB
authors.lastname: Nicia
authors.affiliation: VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: T A
authors.initials: TA
authors.lastname: van Veelen
authors.affiliation: VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Stens
authors.affiliation: Sanquin Blood Supply Foundation, Amsterdam, the Netherlands.
authors.forename: M M W
authors.initials: MM
authors.lastname: Koopman
authors.affiliation: Institute for Cardiovascular Research, VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Boer
mesh_terms: D000328:Adult; D062186:Arterial Pressure / Q000502:physiology; D001782:Blood Donors; D001794:Blood Pressure / Q000502:physiology; D015924:Blood Pressure Monitors; D002302:Cardiac Output / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012372:ROC Curve; D013815:Thermodilution / Q000295:instrumentation / Q000706:statistics & numerical data; D014655:Vascular Resistance / Q000502:physiology