Laser doppler imaging for early detection of hemorrhage

Meghann Lee Kaiser, Allen P. Kong, Earl Steward, Matthew Whealon, Madhukar Patel, David Butler Hoyt, Marianne E. Cinat

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Laser Doppler Imaging (LDI) is a noninvasive means to measure blood flow through the superficial skin capillary plexus using flux units. Our objective was to determine the ability of LDI of the skin to detect and quantify rapid, severe hemorrhage. Methods: Five Yucatan mini-pigs (25-35 kg) underwent controlled hemorrhage of 25 mL/kg blood for 20 minutes. Median flux of a 10 cm × 10 cm area of the lower abdomen was measured at 2-minute intervals from initiation of hemorrhage to resuscitation with concurrent measurement of heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure (MAP). Results: Average time to a change of 5 U in flux following start of hemorrhage was 2.4 minutes. This was significantly faster than time to change in HR (19.2 minutes, p < 0.05) and showed a trend toward more rapid identification of hemorrhage relative to changes in SBP (3.2 minutes, p = 0.157) and MAP (3.6 minutes, p = 0.083). Flux changes occurred at smaller % total blood volume lost than HR (3.94% vs. 28.8%, p < 0.05) and trended toward smaller volume identification than SBP (4.88%, p = 0.180) and MAP (5.36%, p = 0.102). Average correlation (ρ) of blood volume lost to flux was -0.974; HR, 0.346; SBP, -0.978; and MAP, -0.975. A change of 5 flux units was significantly more sensitive for hemorrhage than a change of 5 beats per minute in HR or 5 mm Hg in SBP or MAP (0.596 vs. 0.169, 0.438, and 0.287 respectively, all p < 0.05). Conclusion: LDI is a sensitive, specific, and early means to detect and quantify severe hemorrhage.

Original languageEnglish (US)
Pages (from-to)401-406
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume71
Issue number2
DOIs
StatePublished - Aug 2011
Externally publishedYes

Keywords

  • Hemorrhage
  • Laser Doppler imaging
  • perfusion
  • Skin
  • Vital sign

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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