Venous Physiology Predicts Dehydration in the Pediatric Population

Bonasso, Patrick C.; Sexton, Kevin W.; Hayat, Abul; Wu, Jingxian; Jensen, Hanna K.; Jensen, Morten Ø.; Burford, Jeffrey M.; Dassinger, Melvin S.

doi:10.1016/j.jss.2019.01.036

Cited by 6 publications

(12 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall signal power in the frequency domain was reduced in hypovolemic patients compared to resuscitated patients, with an algorithm developed to predict dehydration that demonstrated 100% sensitivity and specificity. 5 In pediatric patients undergoing complex cranial vault reconstruction, Sobey et al found a linear correlation between NIVA and a net change in volume calculated as a sum of blood loss and fluid/blood administration normalized to body weight (r ¼ 0.67, p < 0.05, n ¼ 14). In the same study MAP, a widely used indicator of volume status in anesthetized children, did not correlate with volume change (r=-0.09, p > 0.05, n ¼ 14).…”

Section: Clinical Applications Of Venous Waveformsmentioning

confidence: 99%

Section: Techniques For Waveform Analysismentioning

confidence: 99%

“…3,4,16,17 A number of other algorithms in the frequency domain have been developed and tested, including calculation of overall signal power or tracking changes in the amplitude of the fundamental pulse frequency across intravascular volume events. 1,2,5,6 Clinical applications of venous waveforms One of the largest clinical applications of volume status assessment is the detection of hemorrhage, which is traditionally difficult to identify clinically. Changes in vital signs are delayed due to neurohumoral compensatory mechanisms that maintain cardiac output until significant blood loss has occurred ($25-35% blood loss).…”

Section: Techniques For Waveform Analysismentioning

confidence: 99%

“…Analysis of venous waveforms has revealed insight into intravascular volume status with clinical implications toward determination of dehydration, hemorrhage, and volume overload in diseases such as heart failure and renal failure (Table 1). [2][3][4][5][6][7][8][9][10]…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Physiology and clinical utility of the peripheral venous waveform

Chang

Leisy

Sobey

et al. 2020

JRSM Cardiovascular Disease

View full text Add to dashboard Cite

The peripheral venous system serves as a volume reservoir due to its high compliance and can yield information on intravascular volume status. Peripheral venous waveforms can be captured by direct transduction through a peripheral catheter, non-invasive piezoelectric transduction, or gleaned from other waveforms such as the plethysmograph. Older analysis techniques relied upon pressure waveforms such as peripheral venous pressure and central venous pressure as a means of evaluating fluid responsiveness. Newer peripheral venous waveform analysis techniques exist in both the time and frequency domains, and have been applied to various clinical scenarios including hypovolemia (i.e. hemorrhage, dehydration) and volume overload.

show abstract

Section: Clinical Applications Of Venous Waveformsmentioning

confidence: 99%

Section: Techniques For Waveform Analysismentioning

confidence: 99%

Section: Techniques For Waveform Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Physiology and clinical utility of the peripheral venous waveform

Chang

Leisy

Sobey

et al. 2020

JRSM Cardiovascular Disease

View full text Add to dashboard Cite

show abstract

“…Analysis of peripheral venous pressure (PVP) waveforms is a novel method of monitoring intravascular volume, especially in cases of dehydration and hemorrhage [ 6 , 7 ], and may provide earlier sensitivity in detection of loss of blood volume. Previously, Bonasso et al demonstrated that PVP waveforms are more sensitive in predicting volume loss than vital signs in a large animal model of bleeding [ 8 ]. Furthermore, PVP has been shown to be a predictor of dehydration in a pediatric cohort who underwent operations for pyloric stenosis.…”

Section: Introductionmentioning

confidence: 99%

Anesthetics affect peripheral venous pressure waveforms and the cross-talk with arterial pressure

Al-Alawi

Henry

Crimmins

et al. 2021

J Clin Monit Comput

Self Cite

View full text Add to dashboard Cite

Analysis of peripheral venous pressure (PVP) waveforms is a novel method of monitoring intravascular volume. Two pediatric cohorts were studied to test the effect of anesthetic agents on the PVP waveform and cross-talk between peripheral veins and arteries: (1) dehydration setting in a pyloromyotomy using the infused anesthetic propofol and (2) hemorrhage setting during elective surgery for craniosynostosis with the inhaled anesthetic isoflurane. PVP waveforms were collected from 39 patients that received propofol and 9 that received isoflurane. A multiple analysis of variance test determined if anesthetics influence the PVP waveform. A prediction system was built using k-nearest neighbor (k-NN) to distinguish between: (1) PVP waveforms with and without propofol and (2) different minimum alveolar concentration (MAC) groups of isoflurane. 52 porcine, 5 propofol, and 7 isoflurane subjects were used to determine the cross-talk between veins and arteries at the heart and respiratory rate frequency during: (a) during and after bleeding with constant anesthesia, (b) before and after propofol, and (c) at each MAC value. PVP waveforms are influenced by anesthetics, determined by MANOVA: p value < 0.01, η2 = 0.478 for hypovolemic, and η2 = 0.388 for euvolemic conditions. The k-NN prediction models had 82% and 77% accuracy for detecting propofol and MAC, respectively. The cross-talk relationship at each stage was: (a) ρ = 0.95, (b) ρ = 0.96, and (c) could not be evaluated using this cohort. Future research should consider anesthetic agents when analyzing PVP waveforms developing future clinical monitoring technology that uses PVP.

show abstract