Circulating blood volume measurements correlate poorly with pulmonary artery catheter measurements

Determination of the intravascular volume status of a critically ill surgical patient is paramount for appropriate fluid and cardiovascular management. Many clinical parameters have been utilized to estimate intravascular volume but none are precise indicators of circulating blood volume. The purpose of this observational pilot study was to compare measured blood volume with hemodynamic parameters obtained from the pulmonary artery catheter and to determine if incorporation of these measurements altered treatment decisions in critically ill surgical patients.

Blood volume measurements were prospectively obtained in twenty surgical intensive care unit patients with a pulmonary artery catheter when intravascular volume status was deemed uncertain by traditional clinical parameters.

There was a statistically significant, but weak, correlation between blood volume results and pulmonary artery occlusion pressure, but no correlation with central venous pressure, cardiac index, and stroke volume index. Blood volume information altered treatment in 21% of instances, and 5 of these 6 patients demonstrated a favorable clinical response.

Circulating blood volume measurements may be useful in critically ill surgical patients when clinical appraisal of intravascular volume is uncertain. This remains to be validated in a larger, prospective randomized trial.