Decreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage

J. M. Dalton, Dennis Gore, R. G. Makhoul, M. R. Fisher, E. J. DeMaria

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. Design: Prospective, nonrandomized, controlled trial. Setting: Clinical research center. Participants: Seven fasting, healthy male and female volunteers, ranging in age from 25 to 37 yrs and weighing 60 to 90 kg. Interventions: Pulse, blood pressure, hematocrit, and duplex Doppler measurements of the peak systolic velocity and time averaged velocity of the subdiaphragmatic aorta, celiac artery, and superior mesenteric artery were obtained at four time points. Time points I and II were on separate days before hemorrhage and consisted of routine blood donation of 450 mL. Time point III was immediately after blood donation. Time point IV was 24 hrs after donation. Estimated blood flow was calculated from time averaged velocity (estimated blood flow = 60[vessel cross-sectional area][time averaged velocity]). Measurements and Main Results: Vital signs and hematocrit remained without significant change at all time points. Peak systolic velocity, time averaged velocity, and estimated blood flow were also unchanged between measurements at time points I and II. However, after a mean reduction of 9.1% of total blood volume, duplex ultrasound detected significant decreases of 14.5% in celiac artery and superior mesenteric artery peak systolic velocity, as well as 15.1%, 17.3%, and 20.2% decreases in aorta, celiac artery and superior mesenteric artery time averaged velocity and estimated blood flow, respectively (all values p < .05 vs. baseline, Duncan's multiple range test). All measured variables returned to baseline 24 hrs after hemorrhage. Conclusions: Noninvasive duplex Doppler measurements of splanchnic peak systolic velocity, time averaged velocity, and estimated blood flow are reproducible and sensitive to small changes in intravascular volume. These data suggest a potential clinical role for duplex imaging in the treatment of critically ill patients to guide therapy to optimize splanchnic perfusion.

Original languageEnglish (US)
Pages (from-to)491-497
Number of pages7
JournalCritical Care Medicine
Volume23
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Viscera
Perfusion
Hemorrhage
Blood Flow Velocity
Celiac Artery
Superior Mesenteric Artery
Blood Donors
Hematocrit
Aorta
Blood Pressure
Hypovolemia
Vital Signs
Blood Volume
Critical Illness
Volunteers
Fasting

Keywords

  • blood
  • blood flow velocity
  • critical illness
  • Doppler ultrasound
  • hemorrhage
  • regional blood flow
  • splanchnic circulation
  • ultrasonics
  • ultrasonography

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Decreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage. / Dalton, J. M.; Gore, Dennis; Makhoul, R. G.; Fisher, M. R.; DeMaria, E. J.

In: Critical Care Medicine, Vol. 23, No. 3, 1995, p. 491-497.

Research output: Contribution to journalArticle

Dalton, J. M. ; Gore, Dennis ; Makhoul, R. G. ; Fisher, M. R. ; DeMaria, E. J. / Decreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage. In: Critical Care Medicine. 1995 ; Vol. 23, No. 3. pp. 491-497.
@article{793dff5601ad4feabdc64a575e0f2682,
title = "Decreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage",
abstract = "Objectives: To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. Design: Prospective, nonrandomized, controlled trial. Setting: Clinical research center. Participants: Seven fasting, healthy male and female volunteers, ranging in age from 25 to 37 yrs and weighing 60 to 90 kg. Interventions: Pulse, blood pressure, hematocrit, and duplex Doppler measurements of the peak systolic velocity and time averaged velocity of the subdiaphragmatic aorta, celiac artery, and superior mesenteric artery were obtained at four time points. Time points I and II were on separate days before hemorrhage and consisted of routine blood donation of 450 mL. Time point III was immediately after blood donation. Time point IV was 24 hrs after donation. Estimated blood flow was calculated from time averaged velocity (estimated blood flow = 60[vessel cross-sectional area][time averaged velocity]). Measurements and Main Results: Vital signs and hematocrit remained without significant change at all time points. Peak systolic velocity, time averaged velocity, and estimated blood flow were also unchanged between measurements at time points I and II. However, after a mean reduction of 9.1{\%} of total blood volume, duplex ultrasound detected significant decreases of 14.5{\%} in celiac artery and superior mesenteric artery peak systolic velocity, as well as 15.1{\%}, 17.3{\%}, and 20.2{\%} decreases in aorta, celiac artery and superior mesenteric artery time averaged velocity and estimated blood flow, respectively (all values p < .05 vs. baseline, Duncan's multiple range test). All measured variables returned to baseline 24 hrs after hemorrhage. Conclusions: Noninvasive duplex Doppler measurements of splanchnic peak systolic velocity, time averaged velocity, and estimated blood flow are reproducible and sensitive to small changes in intravascular volume. These data suggest a potential clinical role for duplex imaging in the treatment of critically ill patients to guide therapy to optimize splanchnic perfusion.",
keywords = "blood, blood flow velocity, critical illness, Doppler ultrasound, hemorrhage, regional blood flow, splanchnic circulation, ultrasonics, ultrasonography",
author = "Dalton, {J. M.} and Dennis Gore and Makhoul, {R. G.} and Fisher, {M. R.} and DeMaria, {E. J.}",
year = "1995",
doi = "10.1097/00003246-199503000-00013",
language = "English (US)",
volume = "23",
pages = "491--497",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Decreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage

AU - Dalton, J. M.

AU - Gore, Dennis

AU - Makhoul, R. G.

AU - Fisher, M. R.

AU - DeMaria, E. J.

PY - 1995

Y1 - 1995

N2 - Objectives: To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. Design: Prospective, nonrandomized, controlled trial. Setting: Clinical research center. Participants: Seven fasting, healthy male and female volunteers, ranging in age from 25 to 37 yrs and weighing 60 to 90 kg. Interventions: Pulse, blood pressure, hematocrit, and duplex Doppler measurements of the peak systolic velocity and time averaged velocity of the subdiaphragmatic aorta, celiac artery, and superior mesenteric artery were obtained at four time points. Time points I and II were on separate days before hemorrhage and consisted of routine blood donation of 450 mL. Time point III was immediately after blood donation. Time point IV was 24 hrs after donation. Estimated blood flow was calculated from time averaged velocity (estimated blood flow = 60[vessel cross-sectional area][time averaged velocity]). Measurements and Main Results: Vital signs and hematocrit remained without significant change at all time points. Peak systolic velocity, time averaged velocity, and estimated blood flow were also unchanged between measurements at time points I and II. However, after a mean reduction of 9.1% of total blood volume, duplex ultrasound detected significant decreases of 14.5% in celiac artery and superior mesenteric artery peak systolic velocity, as well as 15.1%, 17.3%, and 20.2% decreases in aorta, celiac artery and superior mesenteric artery time averaged velocity and estimated blood flow, respectively (all values p < .05 vs. baseline, Duncan's multiple range test). All measured variables returned to baseline 24 hrs after hemorrhage. Conclusions: Noninvasive duplex Doppler measurements of splanchnic peak systolic velocity, time averaged velocity, and estimated blood flow are reproducible and sensitive to small changes in intravascular volume. These data suggest a potential clinical role for duplex imaging in the treatment of critically ill patients to guide therapy to optimize splanchnic perfusion.

AB - Objectives: To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. Design: Prospective, nonrandomized, controlled trial. Setting: Clinical research center. Participants: Seven fasting, healthy male and female volunteers, ranging in age from 25 to 37 yrs and weighing 60 to 90 kg. Interventions: Pulse, blood pressure, hematocrit, and duplex Doppler measurements of the peak systolic velocity and time averaged velocity of the subdiaphragmatic aorta, celiac artery, and superior mesenteric artery were obtained at four time points. Time points I and II were on separate days before hemorrhage and consisted of routine blood donation of 450 mL. Time point III was immediately after blood donation. Time point IV was 24 hrs after donation. Estimated blood flow was calculated from time averaged velocity (estimated blood flow = 60[vessel cross-sectional area][time averaged velocity]). Measurements and Main Results: Vital signs and hematocrit remained without significant change at all time points. Peak systolic velocity, time averaged velocity, and estimated blood flow were also unchanged between measurements at time points I and II. However, after a mean reduction of 9.1% of total blood volume, duplex ultrasound detected significant decreases of 14.5% in celiac artery and superior mesenteric artery peak systolic velocity, as well as 15.1%, 17.3%, and 20.2% decreases in aorta, celiac artery and superior mesenteric artery time averaged velocity and estimated blood flow, respectively (all values p < .05 vs. baseline, Duncan's multiple range test). All measured variables returned to baseline 24 hrs after hemorrhage. Conclusions: Noninvasive duplex Doppler measurements of splanchnic peak systolic velocity, time averaged velocity, and estimated blood flow are reproducible and sensitive to small changes in intravascular volume. These data suggest a potential clinical role for duplex imaging in the treatment of critically ill patients to guide therapy to optimize splanchnic perfusion.

KW - blood

KW - blood flow velocity

KW - critical illness

KW - Doppler ultrasound

KW - hemorrhage

KW - regional blood flow

KW - splanchnic circulation

KW - ultrasonics

KW - ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=0028920647&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028920647&partnerID=8YFLogxK

U2 - 10.1097/00003246-199503000-00013

DO - 10.1097/00003246-199503000-00013

M3 - Article

VL - 23

SP - 491

EP - 497

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 3

ER -