TY  - JOUR
AU  - Markevicius, Vytautas
AU  - Cincikas, Darius
AU  - Porvaneckas, Narunas
AU  - Stankevicius, Edgaras
AU  - Navikas, Dangirutis
AU  - Andriukaitis, Darius
AU  - Sipylaite, Jurate
AU  - Svediene, Saule
AU  - Uvarovas, Valentinas
AU  - Satkauskas, Igoris
AU  - Kvederas, Giedrius
AU  - Valinevicius, Algimantas
AU  - Zilys, Mindaugas
AU  - Andrijauskas, Audrius
PY  - 2016/02/01
Y2  - 2025/01/02
TI  - Revised Evaluation of Hemodilution Response in the Semi-Closed Loop Infusion System
JF  - Elektronika ir Elektrotechnika
JA  - ELEKTRON ELEKTROTECH
VL  - 22
IS  - 1
SE  - 
DO  - 10.5755/j01.eee.22.1.12826
UR  - https://eejournal.ktu.lt/index.php/elt/article/view/12826
SP  - 57-63
AB  - &lt;p&gt; &lt;/p&gt;&lt;p class=&quot;Abstract&quot;&gt;A mini volume loading test (mVLT) method is used for decision making in our prototype semi-closed loop infusion system (SCLIS). The mVLT fluid protocol consists of hemodilution response-guided mini fluid challenges. Each mini fluid challenge (MFC) consists of a 2.5 ml kg&lt;sup&gt;-1&lt;/sup&gt;–5 ml kg&lt;sup&gt;-1&lt;/sup&gt; crystalloid bolus infused over 2 min–5 min and followed by a 5 min period with no fluids. Arterial plasma dilution efficacy (aPDE) of a MFC is calculated from invasively measured hemoglobin (aHb) before and after each MFC. Capillary plasma dilution efficacy (&lt;em&gt;cPDE&lt;/em&gt;) is calculated from non-invasively measured hemoglobin (SpHb). The zero or negative arterio-capillary plasmadilution efficacy difference (&lt;em&gt;acPED&lt;/em&gt; ≤ 0 p.d.u.) is an indication of &lt;em&gt;hemodilution non-response&lt;/em&gt; and &lt;em&gt;imminent edema&lt;/em&gt;. However, it requires both invasive and non-invasive hemoglobin measurements. A non-invasive assessment of hemodilution response within the mVLT method would increase its practical application and reduce costs further enhancing its applicability in the SCLIS. This possibility exists if the &lt;em&gt;cPDE&lt;/em&gt; could reliably predict the &lt;em&gt;acPED&lt;/em&gt; value or the hemodilution &lt;em&gt;response&lt;/em&gt; (the presence of &lt;em&gt;acPED&lt;/em&gt; within a range of &amp;gt; 0) or &lt;em&gt;non-response&lt;/em&gt; (&lt;em&gt;acPED&lt;/em&gt; ≤ 0).&lt;/p&gt; &lt;p class=&quot;Abstract&quot;&gt;We report a retrospective observational study in an elective total knee arthoplasty (TKA) setting. The 2.5 ml kg&lt;sup&gt;-1&lt;/sup&gt; boluses were used in six MFCs in both pre- and post-operative mVLT sessions. The primary objective was to assess the accuracy of &lt;em&gt;cPDE&lt;/em&gt; in predicting the hemodilution &lt;em&gt;response&lt;/em&gt; using the &lt;em&gt;receiver operating characteristic&lt;/em&gt; (ROC) curve and &lt;em&gt;gray zone&lt;/em&gt; approaches. Our secondary objective was to investigate the feasibility of a statistical optimization method (SOM) in predicting the &lt;em&gt;acPED&lt;/em&gt;.&lt;/p&gt; &lt;p class=&quot;Abstract&quot;&gt;The analysis included 480 paired values of &lt;em&gt;cPDE&lt;/em&gt; and &lt;em&gt;acPED&lt;/em&gt;. The best cut-off value for &lt;em&gt;cPDE&lt;/em&gt; was 0.015 p.d.u. (specificity = 0.84, sensitivity = 0.90). The &lt;em&gt;gray zone&lt;/em&gt; identified a range of &lt;em&gt;cPDE&lt;/em&gt; values between 0.013 and 0.028 (p.d.u.) for which the hemodilution response could not be indicated reliably. The 14 % of the &lt;em&gt;cPDE&lt;/em&gt; values were in this range.&lt;/p&gt; &lt;p class=&quot;Abstract&quot;&gt;The non-invasive evaluation of hemodilution response is acceptably accurate in the perioperative TKA setting. The mVLT algorithm within our prototype SCLIS was upgraded by implementing the results of the present study.&lt;/p&gt;&lt;p&gt;DOI: &lt;a href=&quot;http://dx.doi.org/10.5755/j01.eee.22.1.12826&quot;&gt;http://dx.doi.org/10.5755/j01.eee.22.1.12826&lt;/a&gt;&lt;/p&gt;
ER  -