Limited agreement between two noninvasive measurements of blood volume during fluid removal: ultrasound of inferior vena cava and finger-clip spectrophotometry of hemoglobin concentration.

Abstract:

OBJECTIVE:Plots of blood volume measurements over time (profiles) may identify euvolemia during fluid removal for acute heart failure. We assessed agreement between two noninvasive measurements of blood volume profiles during mechanical fluid removal, which exemplifies the interstitial fluid shifts that occur during diuretic-induced fluid removal. APPROACH:During hemodialysis we compared change in maximum diameter of the inferior vena cava by ultrasound ([Formula: see text]) to change in relative blood volume derived from capillary hemoglobin concentration from finger-clip spectrophotometry (RBVSpHb). We grouped profiles of these measurements into three distinct shapes using an unbiased, data-driven modeling technique. METHODS:Fifty patients who were not in acute heart failure underwent a mean of five paired measurements while an average of 1.3 liters of fluid was removed over 2 h during single hemodialysis sessions. [Formula: see text] changed  -1.0 mm (95% CI  -1.9 to  -0.2 mm) and the RBVSpHb changed  -1.1% (95% CI  -2.7 to  +0.5%), but these changes were not correlated (r  -0.04, 95% CI  -0.32 to  +0.24). Nor was there agreement between categorization of profiles of change in the two measurements (kappa  -0.1, 95% CI  -0.3 to  +0.1). SIGNIFICANCE:[Formula: see text] and RBVSpHb estimates of blood volume do not agree during mechanical fluid removal, likely because regional changes in blood flow and pressure modify IVC dimensions as well as changes total blood volume.

journal_name

Physiol Meas

authors

Lucas BP,D'Addio A,Block C,Manning H,Remillard B,Leiter JC

doi

10.1088/1361-6579/ab21af

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

065003

issue

6

eissn

0967-3334

issn

1361-6579

journal_volume

40

pub_type

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