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British Journal of Anaesthesia, 2001, Vol. 86, No. 6 743-746
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial I

Circulating volume and clinical assessment of the circulation

M. Palazzo

Experience teaches that to place reliance upon a single sign is precarious. Compare this sign and that, and confident recognition of the patient’s state grows as these signs group themselves together to form a harmonious picture.

Sir Thomas Lewis1

One of the biggest critical care challenges is a septic patient with massive apparent fluid losses. The losses result from increased capillary permeability and third space sequestration, confounded by reduced vascular tone mediated through induced nitric oxide production, which might be associated with myocardial dysfunction.2 These changes lead to a fall in cardiac output and profound hypotension, which result in poor organ perfusion, multiple organ failure and death. It would probably come as a surprise to most scientists, therefore, that, whereas clinicians have good techniques for measuring cardiac output, there are no easily undertaken bedside methods for measuring total circulating blood volume.

Circulating volume is a major determinant of cardiac output . . . [Full Text of this Article]

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Blood volume may need to be standardised for gastric pHi to be helpful.
Richard G Fiddian-Green
British Journal of Anaesthesia, 27 Oct 2006 [Full text]