Peripheral venous waveform analysis for detecting early hemorrhage: a pilot study

Peripheral Venous Waveform Analysis for Detecting Hemorrhage and Iatrogenic Volume Overload in a Porcine Model

“…Our animal data are in agreement with findings of Sileshi, et al which demonstrated hemorrhage detection after approximately 6% estimated blood loss in a cardiac surgery population (31).…”

“…(16,17) We not only demonstrated significant changes in f 1 during hemorrhage, but also a return of f 1 to baseline with transfusion of a matched quantity of autologous blood during resuscitation ( Figure 2). Detecting a return to euvolemia has great potential to enhance accurate goal directed volume resuscitation to prevent fluid overload in the hemorrhaging patient.…”

“…This method has been used to quantify changes associated with lower body negative pressure, a simulation of hemorrhage, in spontaneously breathing subjects (16 (17). Moreover, this study demonstrated that PIVA was more sensitive to acute changes in circulating blood volume than standard vital signs and invasive pulmonary arterial monitoring.…”

Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis

“…18 Venous waves are generated by the cardiac cycle and propagation of the wave (and harmonics) is modulated by venous compliance (C ¼ DV/DP, where V¼volume and P¼pressure). 11 The venous system is a low-pressure, highly compliant system that can accommodate large changes in volume with only minimal changes in pressure. 19 Compensatory vasoconstriction of the venous system to volume depletion diverts blood from the periphery to the central vasculature in order to maintain cardiac output and ultimately end-organ perfusion.…”

“…10 11 PIVA has been shown to detect as little as 6% blood volume loss in human model of haemorrhage model. 11 Further, PIVA has been shown to reflect blood volume changes more sensitively than standard vital sign monitoring during haemorrhage, resuscitation and iatrogenic volume overload in a porcine species. 10 In this study, using haemodialysis (HD) as a model for controlled, quantifiable fluid loss, we compared PIVA, PVP and standard vital signs during HD.…”