{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:38:47Z","timestamp":1725755927038},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100011019","name":"National Research, Development and Innovation Office","doi-asserted-by":"crossref","award":["NKFIH K116689"],"award-info":[{"award-number":["NKFIH K116689"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p>The aim of this study was to compare stroke volume (SVI) to cardiac index (CI) guided resuscitation in a bleeding-resuscitation experiment. Twenty six pigs were randomized and bled in both groups till baseline SVI (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:msub><mml:mrow><mml:mi>T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">b<\/mml:mi><mml:mi mathvariant=\"normal\">s<\/mml:mi><mml:mi mathvariant=\"normal\">l<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>) dropped by 50% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:msub><mml:mrow><mml:mi>T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn fontstyle=\"italic\">0<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>), followed by resuscitation with crystalloid solution until initial SVI or CI was reached (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:msub><mml:mrow><mml:mi>T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn fontstyle=\"italic\">4<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>). Similar amount of blood was shed but animals received significantly less fluid in the CI-group as in the SVI-group: median = 900 (interquartile range: 850\u20131780) versus 1965 (1584\u20132165) mL,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">0.02<\/mml:mn><\/mml:math>, respectively. In the SVI-group all variables returned to their baseline values, but in the CI-group animals remained underresuscitated as indicated by SVI, heart rate (HR) and stroke volume variation (SVV), and central venous oxygen saturation (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">S<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">c<\/mml:mi><mml:mi mathvariant=\"normal\">v<\/mml:mi><\/mml:mrow><\/mml:msub><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">O<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn mathvariant=\"normal\">2<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:math>) at<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mrow><mml:msub><mml:mrow><mml:mi>T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn fontstyle=\"italic\">4<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>as compared to<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mrow><mml:msub><mml:mrow><mml:mi>T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">b<\/mml:mi><mml:mi mathvariant=\"normal\">s<\/mml:mi><mml:mi mathvariant=\"normal\">l<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>: SVI = 23.8 \u00b1 5.9 versus 31.4 \u00b1 4.7\u2009mL, HR: 117 \u00b1 35 versus 89 \u00b1 11\/min SVV: 17.4 \u00b1 7.6 versus 11.5 \u00b1 5.3%, and<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">S<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">c<\/mml:mi><mml:mi mathvariant=\"normal\">v<\/mml:mi><\/mml:mrow><\/mml:msub><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">O<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn mathvariant=\"normal\">2<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:math>: 64.1 \u00b1 11.6 versus 79.2 \u00b1 8.1%,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn fontstyle=\"italic\">0.05<\/mml:mn><\/mml:math>, respectively. Our results indicate that CI-based goal-directed resuscitation may result in residual hypovolaemia, as bleeding caused stress induced tachycardia \u201cnormalizes\u201d CI, without restoring adequate SVI. As the SVI-guided approach normalized most hemodynamic variables, we recommend using SVI instead of CI as the primary goal of resuscitation during acute bleeding.<\/jats:p>","DOI":"10.1155\/2015\/160979","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T19:38:37Z","timestamp":1444765117000},"page":"1-8","source":"Crossref","is-referenced-by-count":4,"title":["Goal-Directed Resuscitation Aiming Cardiac Index Masks Residual Hypovolemia: An Animal Experiment"],"prefix":"10.1155","volume":"2015","author":[{"given":"Kriszti\u00e1n","family":"T\u00e1nczos","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, University of Szeged, 6 Semmelweis Street, Szeged 6725, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1rton","family":"N\u00e9meth","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, 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