Anaesthesia
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Observational Study
Detection of volume loss using the Nexfin device in blood donors.
We investigated which haemodynamic parameters derived from Nexfin non-invasive continuous arterial blood pressure measurements are optimal to detect controlled volume loss in spontaneously breathing subjects. Haemodynamic monitoring was performed in 40 whole-blood donors. ⋯ The area under the receiver operating characteristic curve to detect volume loss was highest for cardiac index (0.94, 95% CI 0.88-0.99) and systemic vascular resistance (0.90, 95% CI 0.82-0.99). Nexfin is a non-invasive haemodynamic monitor that can feasibly detect volaemic changes in spontaneously breathing subjects.
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Isotonic saline is a widely-used infusion fluid, although the associated chloride load may cause metabolic acidosis and impair kidney function in young, healthy volunteers. We wished to examine whether these effects also occurred in the elderly, and conducted a crossover study in 13 men with a mean age of 73 years (range 66-84), who each received intravenous infusions of 1.5 l of Ringer's acetate and of isotonic saline. ⋯ The glomerular filtration rate increased in response to both fluids, but more after the Ringer's acetate (p < 0.03). Pre-infusion fluid retention, as evidenced by high urinary osmolality (> 700 mOsmol.kg(-1) ) and/or creatinine (> 7 mmol.l(-1) ), was a strong factor governing the responses to both fluid loads.