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Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis  K.M. Hocking, B.D. Alvis, F. Baudenbacher,

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Presentation on theme: "Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis  K.M. Hocking, B.D. Alvis, F. Baudenbacher,"— Presentation transcript:

1 Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis  K.M. Hocking, B.D. Alvis, F. Baudenbacher, R. Boyer, C.M. Brophy, I. Beer, S. Eagle  British Journal of Anaesthesia  Volume 119, Issue 6, Pages (December 2017) DOI: /bja/aex271 Copyright © 2017 The Author(s) Terms and Conditions

2 Fig. 1 Peripheral i.v. analysis (PIVA) before and after dialysis. Representative peripheral venous waveform obtained from a peripheral i.v. cannula before (A) and after (C) haemodialysis. Fast Fourier transform (FFT) of the corresponding peripheral venous waveform before (B) and after (C) haemodialysis. The frequencies (Hz) F0 and F1 correspond to the respiratory rate and heart rate, respectively. The amplitude of the F1 peak decreases from before (B) to after (D) dialysis, reflecting volume removal. British Journal of Anaesthesia  , DOI: ( /bja/aex271) Copyright © 2017 The Author(s) Terms and Conditions

3 Fig. 2 Peripheral i.v. analysis (PIVA) correlation with respiration rate and heart rate. The correlation between the low frequency (A, n=37) F0 signal with the monitored respiratory rate (thoracic impedence measurements) and the higher frequency (B, n=37) F1 signal with the monitored heart rate (electrocardiogram) as compared with the signal obtained with the IntelliVue bedside monitoring system (Philips North America Corp., Andover, MA, USA). British Journal of Anaesthesia  , DOI: ( /bja/aex271) Copyright © 2017 The Author(s) Terms and Conditions

4 Fig. 3 Correlation between dialysate volume removed ml kg-1 and change in PIVA signal. This regression analysis represents the linear correlation between the amount of dialysate removed and the percentage change in PIVA signal (R2=0.77) (A; n=31). There was no significant correlation between the amount of intravascular volume removed and change in mPVP (R2=0.03) (B; n=34), MAP (R2=0.013) (C; n=34) and heart rate (R2=0.0003) (D; n=35). PIVA, peripheral i.v. analysis; MAP, mean arterial pressure; mPVP, mean peripheral venous pressure. British Journal of Anaesthesia  , DOI: ( /bja/aex271) Copyright © 2017 The Author(s) Terms and Conditions

5 Fig 4 Sensitivity and specificity of PIVA vs PVP for volume of dialysate removed. Receiver operator curve (ROC) of PIVA signal (AUC=0.890) and PVP (AUC=0.482) in patients with a 20 ml kg–1 volume loss during dialysis. PIVA, peripheral i.v. analysis; PVP, peripheral venous pressure; AUC, area under the curve. British Journal of Anaesthesia  , DOI: ( /bja/aex271) Copyright © 2017 The Author(s) Terms and Conditions


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