Hypovolemia Clinical Trial
Official title:
Effects of Low Central Volume and Intermittent Positive Pressure Ventilation on the Heart Rate Variability
Heart Rate Variability (HRV) analysis has been studied in the critically ill patients although it is affected by several uncontrolled variables in the clinical conditions. The aim of this trial is to measure the effects of mildly reduced central volume and cyclic variation of intrathoracic pressure on the variables frequently used to describe the HRV.
Twelve healthy volunteers will be studied. Mild hypovolemia will be induced by 12 hours
fasting from food and drinks. At 8.30 AM the study protocol will start. The studied subjects
will lie calm supine in a ICU bed able to provide passive head up and head down tilt. They
will be connected to a Siemens SC9000 monitor showing their ECG waves and to a Nexfin (BMEYE)
monitor for continuous noninvasive blood pressure (NBP) assessment. Both waves (ECG and NBP)
will be recorded on a laptop PC through analogic/digital input/output converter (PowerLab
8/35, ADinstruments). The studied subjects will undergo to a sequence of (1) spontaneous
breathing at 10 degrees head up, (2) spontaneous breathing at 7 degrees head down, (3)
noninvasive ventilation at 10 degrees head up, and (4) noninvasive ventilation at 7 degrees
head down. The sequence 1-2-3-4 will be randomized. After this four phases, a fluid challenge
of ringer acetate 15ml*kg will be intravenously administered and the a sequence 1-2-3-4 will
be repeated after a new randomization. Noninvasive ventilation will be provided with a facial
mask with ventilatory setting: Psupp 8 cmH2O, PEEP 5 cmH2O, FiO2 0.28. Psupp will be
decreased by 2 cmH2O steps if the inspiratory tidal volume will be >10ml*kg. During both
spontaneous breathing and noninvasive ventilation the subjects will breathe following a
metronome at 18bpm.
HRV analysis will be conducted following the recommendation of the Task Force of the European
Society of Cardiology and the North American Society of Pacing and Electrophysiology (see
reference).
Furthermore, the healthy volunteers will be studied by trans-thoracic ultrasound assessment
with a Philips EPIQ7 sonographer, during each study phase.
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