Pulse Oximeter Plethysmograph Variation During Hemorrhage in Beta-Blocker–Treated Swine

Yoon Sun Jung, Woo Sang Cho, Gil Joon Suh, Jung Chan Lee, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, So Mi Shin, Min Woo Kang, Min Sung Lee, Byeongtak Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Beta-blockers blunt the stress response to hemorrhage. Our aim was to investigate the feasibility of noninvasive pulse oximeter plethysmographic waveform variation (PoPV) for predicting blood volume loss in an esmolol-treated swine hemorrhagic shock model. Materials and Methods: Controlled hemorrhage was induced in eight male domestic pigs. In four pigs, a total of 15% and 30% blood volume was drawn step-by-step over 10 min in each step (controlled hemorrhage–only pigs). In the other four pigs, the heart rate (HR) was reduced and maintained by 30% from baseline by esmolol infusion before controlled hemorrhage (esmolol-treated pigs). Diagnostic abilities of HR, pulse pressure variation (PPV), PoPV, and mean arterial pressure for 15% and 30% blood volume loss were determined by the area under the receiver operating characteristic curve (AUC). Results: PoPV was well correlated with PPV in controlled hemorrhage–only pigs (r = 0.717) and esmolol-treated pigs (r = 0.532). In controlled hemorrhage-only pigs, HR (AUC = 0.841 and 0.864), PPV (0.878 and 0.843), and PoPV (0.779 and 0.793) accurately predicted 15% and 30% of blood volume loss. In esmolol-treated pigs, the diagnostic ability of HR was decreased (AUC = 0.766 and 0.733). However, diagnostic abilities of PPV (0.848 and 0.804) and PoPV (0.808 and 0.842) were not deteriorated. Conclusions: The diagnostic ability of HR for blood volume loss was blunted by esmolol. However, those of PPV and PoPV were not altered. PoPV may be considered to be a useful noninvasive tool to predict blood volume loss in injured patients taking beta-blockers.

Original languageEnglish
Pages (from-to)468-475
Number of pages8
JournalJournal of Surgical Research
Volume256
DOIs
StatePublished - Dec 2020

Keywords

  • Adrenergic beta-antagonists
  • Hemorrhagic
  • Oximetry
  • Pulse wave analysis
  • Shock
  • Swine

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