R. Pizov, A. Eden, D. Bystritski, E. Kalina, A. Tamir, S. Gelman

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Presentation transcript:

Hypotension during gradual blood loss: waveform variables response and absence of tachycardia R. Pizov, A. Eden, D. Bystritski, E. Kalina, A. Tamir, S. Gelman British Journal of Anaesthesia Volume 109, Issue 6, Pages 911-918 (December 2012) DOI: 10.1093/bja/aes300 Copyright © 2012 The Author(s) Terms and Conditions

Fig 1 Per cent patients who tolerated and did not tolerate each of the 10 steps of ECBV reduction (each step is 2% of ECBV). British Journal of Anaesthesia 2012 109, 911-918DOI: (10.1093/bja/aes300) Copyright © 2012 The Author(s) Terms and Conditions

Fig 2 Box plots of the number of steps of blood withdrawal that patients tolerated without hypotension. Three groups of patients were compared: patients treated chronically with one of the three types of medications (calcium channel antagonists, ACE-inhibitors, or diuretics) who suffered from COPD; patients not treated with any medications who did not suffer from COPD; and patients who had COPD but received no chronic medication. The box represents the inter-quartile range which contains 50% of the values. The whiskers are lines that extend from the box to the highest and lowest values. *Significant compared with the patients with COPD (P<0.05). COPD patients tolerated blood withdrawal better than patients who did not have COPD, regardless of whether they had concomitant hypertension and were treated with anti-hypertensive medication or not. One patient with COPD who received chronic anti-hypertensive treatment was not included in this analysis. British Journal of Anaesthesia 2012 109, 911-918DOI: (10.1093/bja/aes300) Copyright © 2012 The Author(s) Terms and Conditions

Fig 3 Systolic arterial pressure (SAP), pulse pressure (PP), HR, SAP variations (SPVs), dDown, and PPVs of AP, plethysmographic waveform variations (PWVs), and pulse oximetry PWVs (dPOPs) during all 10 steps of blood withdrawal. n represents the number of patients who developed hypotension at that step. The data are presented as mean (sd); *significant compared with the baseline (BL) (P<0.005). British Journal of Anaesthesia 2012 109, 911-918DOI: (10.1093/bja/aes300) Copyright © 2012 The Author(s) Terms and Conditions

Fig 4 Changes (y-axis % of changes) in standard haemodynamic and waveform variables from the baseline to 10% of ECBV (n=70) reduction and from 10% to 20% of ECBV (n=34) reduction. The blue solid bars represent patients younger than 60 yr of age and the striped green bars represent patients of 60 yr of age and above. SAP, systolic arterial pressure; PP, pulse pressure; HR, heart rate; SPV, systolic pressure variation; PPV, pulse pressure variation; PWV, plethysmographic waveform variation. *P<0.05 compared with patients younger than 60 yr of age. British Journal of Anaesthesia 2012 109, 911-918DOI: (10.1093/bja/aes300) Copyright © 2012 The Author(s) Terms and Conditions