Standardized blood volume changes monitored by capnodynamic hemodynamic variables: An experimental comparative study in pigs

• Published in: Acta anaesthesiologica Scandinavica 2023-08, Vol.67 (7), p.953-963
• Main Authors: Karlsson, Jacob, Hallbäck, Magnus, Svedmyr, Anders, Lönnqvist, Per‐Arne, Wallin, Mats
• Format: Article
• Language: English
• Subjects: Animals; Blood; Blood Pressure; blood re‐transfusion; Blood transfusion; Blood Volume; capnodynamics; Capnography; Carbon dioxide; Cardiac Output; Comparative studies; continuous hemodynamic monitoring; Contours; Correlation; fluid infusion; Fluid Therapy - methods; Heart; Hemodynamics; Hemorrhage; Medicin och hälsovetenskap; PPV; pulse contour analyses; standardized hemorrhage; Stroke Volume; SVV; Swine; Transfusion; Variance analysis
• ISSN: 0001-5172; 1399-6576; 1399-6576
• DOI: 10.1111/aas.14253

Background The capnodynamic method, based on Volumetric capnography and differential Fick mathematics, assess cardiac output in mechanically ventilated subjects. Capnodynamic and established hemodynamic monitoring parameters' capability to depict alterations in blood volume were investigated in a model of standardized hemorrhage, followed by crystalloid and blood transfusion. Methods Ten anesthetized piglets were subjected to controlled hemorrhage (450 mL), followed by isovolemic crystalloid bolus and blood re‐transfusion. Intravascular blood volume, and all hemodynamic variables, were determined twice after each intervention. The investigated hemodynamic variables were: cardiac output and stroke volume for capnodynamics and pulse contour analysis, respectively, pulse pressure and stroke volume variability and mean arterial pressure. One‐way ANOVA and Tukey's test for multiple comparisons were used to identify significant changes. Trending was assessed by correlation and concordance. Result Concordance against intravascular volume changes for capnodynamic cardiac output and stroke volume were 96 and 94%, with correlations r = .78 and .68, (p