{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:31:48Z","timestamp":1770751908546,"version":"3.50.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,23]],"date-time":"2013-05-23T00:00:00Z","timestamp":1369267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Early recognition of hypovolaemia in trauma patients is very important. However, the most often used clinical signs, such as hypotension and tachycardia, lack specificity and sensitivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We propose a non\u2010invasive index of hypovolaemia, the heart to arm time (<jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content>), based on a modified pulse transit time indexed to heart rate. Pulse transit time is the sum of pre\u2010ejection period and vascular transit time. Following pre\u2010load reductions due to hypovolaemia, ventricular diastolic filling time increases causing an increase in pre\u2010ejection\u2010period, pulse transit time, and hence <jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content>. One hundred and four consecutive patients with suspected major trauma were enrolled. The primary aim was to evaluate the use of the <jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content> for detecting haemorrhage in major trauma. The secondary end point was to compare the specificity and sensitivity of <jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content> compared to commonly used indexes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content> was calculated in 84 subjects, 11 of whom were haemorrhagic. <jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content> discriminated haemorrhagic from non\u2010haemorrhagic group (46.8% vs. 66.9%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009&lt;\u20090.0001). The cut\u2010off for <jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content> with the best compromise between sensitivity (90.9%) and specificity (100%) was reached at the 58.78% level. Comparing haemorrhagic and non\u2010haemorrhagic patients, the area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve was 0.952 for <jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content>, 0.835 for heart rate, and 0.911 for systolic blood pressure, showing no significant differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">iHAT<\/jats:styled-content> is a non\u2010invasive index that can identify haemorrhage in trauma patients with high sensitivity and specificity. These data should be considered as an exploration, but any conclusion should be validated in a new set of consecutive patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12135","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T04:45:38Z","timestamp":1369370738000},"page":"929-935","source":"Crossref","is-referenced-by-count":3,"title":["Predicting haemorrhage in pre\u2010hospital traumatic patients: evaluation of the novel heart\u2010to\u2010arm time index"],"prefix":"10.1111","volume":"57","author":[{"given":"M.","family":"VETTORELLO","sequence":"first","affiliation":[{"name":"AAT 118 Milano Italy Emergency Operations Center and Helicopter Emergency Medical System AREU  Lombardia Italy"},{"name":"Anesthesia and Intensive Care Unit I Department of Perioperative Medicine and Intensive Care \u2018Niguarda Ca' Granda\u2019 Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. M.","family":"SANTAMBROGIO","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit I Department of Perioperative Medicine and Intensive Care \u2018Niguarda Ca' Granda\u2019 Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. R.","family":"CALINI","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit I Department of Perioperative Medicine and Intensive Care \u2018Niguarda Ca' Granda\u2019 Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"TIZZONI","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit Department San Gerardo University Hospital  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"MARCONI","sequence":"additional","affiliation":[{"name":"AAT 118 Milano Italy Emergency Operations Center and Helicopter Emergency Medical System AREU  Lombardia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. G.","family":"LIPPI","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit I Department of Perioperative Medicine and Intensive Care \u2018Niguarda Ca' Granda\u2019 Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"SESANA","sequence":"additional","affiliation":[{"name":"AAT 118 Milano Italy Emergency Operations Center and Helicopter Emergency Medical System AREU  Lombardia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"CHIARA","sequence":"additional","affiliation":[{"name":"Emergency Department and Trauma Team \u2018Niguarda C\u00e0 Granda\u2019 Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"FUMAGALLI","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit I Department of Perioperative Medicine and Intensive Care \u2018Niguarda Ca' Granda\u2019 Hospital  Milan Italy"},{"name":"Department of Experimental Medicine University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,5,23]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"64","volume-title":"Shock. 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