Katzarski KS, Waniewski J, Bergstrom J
Determination of absolute blood volume by continuous
hematocrit monitoring
23rd ESAO Congress, Warsaw
Int J Artif Organs
(Sep) 10:504 1996
The people interested in on-line hematocrit monitoring would love to
be able to measure actual blood volume rather than just hematocrit.
There is evidence that hypotension may occur at a reproducible level
of blood volume. As long as red cell mass stays constant, the
absolute blood volume will be reflected by the hematocrit, but as we
all know, red cell mass fluctuates considerably in ESRD patients. A
method of estimating total blood volume from the rate of refilling
after stopping UF has been proposed by Schallenberg. Whereas papers
have been published computing blood volume from this refilling method,
it has never been validated against gold standard methods such as
radio-albumin measurement. In this paper from Bergstrom's laboratory,
BV estimated by the refilling method was compared to isotopic BV in 9
chronic HD patients.
There was no correlation between refilling BV and isotopic BV,
suggesting that the refilling BV method doesn't give accurate
determinations of blood volume. Isotopic BV correlated closely with
anthropometric BV. Interestingly, the mean values for refilling BV
and isotopic BV were similar, despite a lack of correlation.
Comment: This paper suggests that it will be more
difficult than previously thought to estimate total blood volume in
dialysis patients. Actually, central blood volume may be more
important than total blood volume; please refer to abstracts in this
area (by Depner, for example) at the 1996 ASN. (John T.
Daugirdas, M.D., University of Illinois at Chicago)
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23rd ESAO Congress, Warsaw
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