Quantification of stroke volume in a simulated healthy volunteer model of traumatic haemorrhage; a comparison of two non-invasive monitoring devices using error grid analysis alongside traditional measures of agreement
| العنوان: | Quantification of stroke volume in a simulated healthy volunteer model of traumatic haemorrhage; a comparison of two non-invasive monitoring devices using error grid analysis alongside traditional measures of agreement |
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| المؤلفون: | Sam D. Hutchings, Jim Watchorn, Rory McDonald, Su Jeffreys, Mark Bates, Sarah Watts, Emrys Kirkman |
| المصدر: | PLoS ONE PLoS ONE, Vol 16, Iss 12, p e0261546 (2021) |
| بيانات النشر: | Public Library of Science, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, Power Grids, Adolescent, Imaging Techniques, Epidemiology, Science, Cerebrovascular Diseases, Equipment, Blood Pressure, Hemorrhage, Bioengineering, Research and Analysis Methods, Vascular Medicine, Diagnostic Radiology, Young Adult, Signs and Symptoms, Medical Conditions, Diagnostic Medicine, Ultrasound Imaging, Medicine and Health Sciences, Power Distribution, Humans, Measurement Equipment, Multidisciplinary, Radiology and Imaging, Hemodynamic Monitoring, Biology and Life Sciences, Stroke Volume, Healthy Volunteers, Energy and Power, Stroke, Neurology, Echocardiography, Medical Risk Factors, Medicine, Engineering and Technology, Medical Devices and Equipment, Female, Clinical Medicine, Research Article, Biotechnology |
| الوصف: | Introduction Haemorrhage is a leading cause of death following traumatic injury and the early detection of hypovolaemia is critical to effective management. However, accurate assessment of circulating blood volume is challenging when using traditional vital signs such as blood pressure. We conducted a study to compare the stroke volume (SV) recorded using two devices, trans-thoracic electrical bioimpedance (TEB) and supra-sternal Doppler (SSD), against a reference standard using trans- thoracic echocardiography (TTE). Methods A lower body negative pressure (LBNP) model was used to simulate hypovolaemia and in half of the study sessions lower limb tourniquets were applied as these are common in military practice and can potentially affect some haemodynamic monitoring systems. In order to provide a clinically relevant comparison we constructed an error grid alongside more traditional measures of agreement. Results 21 healthy volunteers aged 18–40 were enrolled and underwent 2 sessions of LBNP, with and without lower limb tourniquets. With respect to absolute SV values Bland Altman analysis showed significant bias in both non-tourniquet and tourniquet strands for TEB (-42.5 / -49.6 ml), rendering further analysis impossible. For SSD bias was minimal but percentage error was unacceptably high (35% / 48%). Degree of agreement for dynamic change in SV, assessed using 4 quadrant plots showed a seemingly acceptable concordance rate for both TEB (86% / 93%) and SSD (90% / 91%). However, when results were plotted on an error grid, constructed based on expert clinical opinion, a significant minority of measurement errors were identified that had potential to lead to moderate or severe patient harm. Conclusion Thoracic bioimpedance and suprasternal Doppler both demonstrated measurement errors that had the potential to lead to clinical harm and caution should be applied in interpreting the results in the detection of early hypovolaemia following traumatic injury. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::827248a2e75118339e12fa349c05dcf7 http://europepmc.org/articles/PMC8699736 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....827248a2e75118339e12fa349c05dcf7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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