Hypovolemia Clinical Trial
Official title:
Detecting a Central Volume Deficit in Spontaneous Breathing Healthy Volunteers by Systolic Blood Pressure Variation
13 healthy volunteers (4 females) were tilted 45° head-up while breathing through a facemask fitted with an inspiratory and expiratory resistor. A brachial arterial catheter was used to measure blood pressure and thus systolic pressure variation and pulse contour analysis determined stroke volume and thereby cardiac output in order to detect a central volume deficit.
Thirteen healthy volunteers (4 women) at an age of 25 years (range 18-36) were recruited
through www.forsøgsperson.dk.
The volunteers were placed on a tilt table and provided with a facemask with an opening of
30-33 mm. A Hook ring was fitted with an inspiratory resistor, an expiratory resistor, a
combination of the two resistors, or with no resistance and each resistor provides a 7.5
cmH2O threshold resistance. Each resistor was applied for two minutes with variables
obtained in the last minute. The table was then tilted 45° head-up to accumulating blood in
the legs and therefore a reduction in the central blood volume. Conversely, 20° head-down
tilt was used to expand the central blood volume. For each volunteer measurements with the
four respiratory interventions was randomized, whereas the tilt table position was in fixed
order: supine, head-up tilt, and head-down tilt.
Three-lead ECG recorded heart rate. A 20 G arterial catheter was placed in the brachial
artery of the non-dominant arm and connected to a transducer for reading of blood pressure
and stroke volume variation (Vigileo-Flotracâ„¢, version 1.07, Edwards Lifesciences, Nyon,
Switzerland). Also SV and CO variation and the arterial pressure curve were recorded for
subsequent determination of arterial pressure variations. Additionally, a catheter was
placed via a brachial vein to the superior caval vein for recording of central venous
pressure and SvO2. While the subjects were breathing spontaneously, the respiratory rate was
measured by capnography and peripheral oxygen saturation by fingerprobe.
Variation in the arterial pulse pressure (PPV) was 100 x ((PPmax - PPmin) / ((PPmax +
PPmin)/2)), where PPmax and PPmin is the maximal and minimal difference between systolic and
diastolic pressure during the respiratory cycle, respectively. By the same formula systolic
pressure variation (SPV) was calculated.
;
Intervention Model: Single Group Assignment, Masking: Open Label
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