Changes in cardiac output after acute blood loss and position change in man

Abstract

Thoracic bioimpedance cardiac output (Qtbi) was measured at 1-min intervals in 27 volunteers before, during, and after withdrawing 500 ml (3.7 to 8.5 ml/kg; mean 5.8) of blood. The effects of passive leg raising (PLR) and standing on Qtbi were measured before and after blood withdrawal. Arterial oxygen saturation (Sao2), transcutaneous oxygen tension (Ptco2), mean arterial BP (MAP), and heart rate (HR) were also measured before and after blood withdrawal. Thoracic bioimpedance cardiac index (CI) decreased 18% (0.8 ± 0.1 L/min m2, p < .0001) and stroke volume index (SI) decreased 22% (14.8 ± 2.7 ml/beat.m2, p < .0001) after blood withdrawal. HR, MAP, Sao2, and Ptco2 were not significantly different after blood withdrawal. Before blood withdrawal PLR increased CI 6.8% (0.3 ± 0.1 L/min.m2, p < .0001); after blood withdrawal PLR increased CI 11.1% (0.4 ± 0.1 L/min.m2, p < .0001). PLR can increase stroke volume and cardiac output in hypovolemic humans. (Crit Care Med 1989; 17:979)