Baseline Values of the Compensatory Reserve Index in a Healthy Pediatric Population
The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algor...
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| Veröffentlicht in: | Pediatric cardiology Jg. 43; H. 2; S. 344 - 349 |
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| Format: | Journal Article |
| Sprache: | Englisch |
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01.02.2022
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| Abstract | The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algorithm that has been broadly applied to non-invasively estimate hemodynamic vascular adaptations during acute blood loss. So far, there is a lack of baseline values from healthy individuals, which complicates accurately estimating the severity of the hemodynamic compromise. Additionally, the application of this technology in pediatric populations is limited to a few reports, highlighting a marked variability by age, weight, and other physiological parameters. The CRI of 205 healthy subjects from 0 to 60 years of age were prospectively evaluated from January to February 2020 at several public outpatient clinics in El Salvador; vital signs and sociodemographic data were also collected during this period. After data collection, baseline values were classified for each age group. Multiple correlation models were tested between the CRI and the other physiological parameters. CRI value varies significantly for each age group, finding for patients under 18 years old a mean value lower than 0.6, which is currently considered the lower normal limit for adults. CRI presents strong correlations with other physiological variables such as age, weight, estimated blood volume, and heart rate (
R
> 0.8,
R
2 > 0.6,
p
< 0.0001). There is significant variability in the CRI normal values observed in healthy patients based on age, weight, estimated blood volume, and heart rate. |
|---|---|
| AbstractList | The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algorithm that has been broadly applied to non-invasively estimate hemodynamic vascular adaptations during acute blood loss. So far, there is a lack of baseline values from healthy individuals, which complicates accurately estimating the severity of the hemodynamic compromise. Additionally, the application of this technology in pediatric populations is limited to a few reports, highlighting a marked variability by age, weight, and other physiological parameters. The CRI of 205 healthy subjects from 0 to 60 years of age were prospectively evaluated from January to February 2020 at several public outpatient clinics in El Salvador; vital signs and sociodemographic data were also collected during this period. After data collection, baseline values were classified for each age group. Multiple correlation models were tested between the CRI and the other physiological parameters. CRI value varies significantly for each age group, finding for patients under 18 years old a mean value lower than 0.6, which is currently considered the lower normal limit for adults. CRI presents strong correlations with other physiological variables such as age, weight, estimated blood volume, and heart rate (
R
> 0.8,
R
2 > 0.6,
p
< 0.0001). There is significant variability in the CRI normal values observed in healthy patients based on age, weight, estimated blood volume, and heart rate. The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algorithm that has been broadly applied to non-invasively estimate hemodynamic vascular adaptations during acute blood loss. So far, there is a lack of baseline values from healthy individuals, which complicates accurately estimating the severity of the hemodynamic compromise. Additionally, the application of this technology in pediatric populations is limited to a few reports, highlighting a marked variability by age, weight, and other physiological parameters. The CRI of 205 healthy subjects from 0 to 60 years of age were prospectively evaluated from January to February 2020 at several public outpatient clinics in El Salvador; vital signs and sociodemographic data were also collected during this period. After data collection, baseline values were classified for each age group. Multiple correlation models were tested between the CRI and the other physiological parameters. CRI value varies significantly for each age group, finding for patients under 18 years old a mean value lower than 0.6, which is currently considered the lower normal limit for adults. CRI presents strong correlations with other physiological variables such as age, weight, estimated blood volume, and heart rate (R > 0.8, R2 > 0.6, p < 0.0001). There is significant variability in the CRI normal values observed in healthy patients based on age, weight, estimated blood volume, and heart rate. The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algorithm that has been broadly applied to non-invasively estimate hemodynamic vascular adaptations during acute blood loss. So far, there is a lack of baseline values from healthy individuals, which complicates accurately estimating the severity of the hemodynamic compromise. Additionally, the application of this technology in pediatric populations is limited to a few reports, highlighting a marked variability by age, weight, and other physiological parameters. The CRI of 205 healthy subjects from 0 to 60 years of age were prospectively evaluated from January to February 2020 at several public outpatient clinics in El Salvador; vital signs and sociodemographic data were also collected during this period. After data collection, baseline values were classified for each age group. Multiple correlation models were tested between the CRI and the other physiological parameters. CRI value varies significantly for each age group, finding for patients under 18 years old a mean value lower than 0.6, which is currently considered the lower normal limit for adults. CRI presents strong correlations with other physiological variables such as age, weight, estimated blood volume, and heart rate (R > 0.8, R2 > 0.6, p < 0.0001). There is significant variability in the CRI normal values observed in healthy patients based on age, weight, estimated blood volume, and heart rate. The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algorithm that has been broadly applied to non-invasively estimate hemodynamic vascular adaptations during acute blood loss. So far, there is a lack of baseline values from healthy individuals, which complicates accurately estimating the severity of the hemodynamic compromise. Additionally, the application of this technology in pediatric populations is limited to a few reports, highlighting a marked variability by age, weight, and other physiological parameters. The CRI of 205 healthy subjects from 0 to 60 years of age were prospectively evaluated from January to February 2020 at several public outpatient clinics in El Salvador; vital signs and sociodemographic data were also collected during this period. After data collection, baseline values were classified for each age group. Multiple correlation models were tested between the CRI and the other physiological parameters. CRI value varies significantly for each age group, finding for patients under 18 years old a mean value lower than 0.6, which is currently considered the lower normal limit for adults. CRI presents strong correlations with other physiological variables such as age, weight, estimated blood volume, and heart rate (R > 0.8, R2 > 0.6, p < 0.0001). There is significant variability in the CRI normal values observed in healthy patients based on age, weight, estimated blood volume, and heart rate.The objective of this study is to describe the compensatory reserve index (CRI) baseline values in a healthy cohort of healthy pediatric patients and evaluate the existing correlation with other physiological parameters that influence compensatory hemodynamic mechanisms. CRI is a computational algorithm that has been broadly applied to non-invasively estimate hemodynamic vascular adaptations during acute blood loss. So far, there is a lack of baseline values from healthy individuals, which complicates accurately estimating the severity of the hemodynamic compromise. Additionally, the application of this technology in pediatric populations is limited to a few reports, highlighting a marked variability by age, weight, and other physiological parameters. The CRI of 205 healthy subjects from 0 to 60 years of age were prospectively evaluated from January to February 2020 at several public outpatient clinics in El Salvador; vital signs and sociodemographic data were also collected during this period. After data collection, baseline values were classified for each age group. Multiple correlation models were tested between the CRI and the other physiological parameters. CRI value varies significantly for each age group, finding for patients under 18 years old a mean value lower than 0.6, which is currently considered the lower normal limit for adults. CRI presents strong correlations with other physiological variables such as age, weight, estimated blood volume, and heart rate (R > 0.8, R2 > 0.6, p < 0.0001). There is significant variability in the CRI normal values observed in healthy patients based on age, weight, estimated blood volume, and heart rate. |
| Audience | Academic |
| Author | Zablah, Jenny E. Rodriguez, Salvador A. Lara, Claudia Morgan, Gareth J. |
| Author_xml | – sequence: 1 givenname: Salvador A. orcidid: 0000-0001-9786-3651 surname: Rodriguez fullname: Rodriguez, Salvador A. email: Salvador.rodriguezfranco@cuanschutz.edu organization: The Heart Institute, Children’s Hospital Colorado, School of Medicine, University of Colorado – sequence: 2 givenname: Gareth J. orcidid: 0000-0003-1500-9334 surname: Morgan fullname: Morgan, Gareth J. organization: The Heart Institute, Children’s Hospital Colorado, School of Medicine, University of Colorado, Department of Cardiology, University of Colorado Hospital – sequence: 3 givenname: Claudia surname: Lara fullname: Lara, Claudia organization: Departamento de Pediatría, Universidad Dr. José Matías Delgado – sequence: 4 givenname: Jenny E. orcidid: 0000-0002-9146-8551 surname: Zablah fullname: Zablah, Jenny E. organization: The Heart Institute, Children’s Hospital Colorado, School of Medicine, University of Colorado |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34586457$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1097/TA.0000000000001595 10.1097/SHK.0000000000000480 10.1097/SHK.0000000000000323 10.1007/s00246-020-02374-3 10.1177/1535370217694099 10.1097/SHK.0000000000000959 10.1152/ajpregu.00304.2015 10.1097/SHK.0000000000000647 10.1093/icvts/ivy173 10.1097/SHK.0000000000000653 10.1097/TA.0000000000000423 10.1097/SHK.0000000000000632 10.2174/157340312801215782 10.1186/s13256-016-1019-z 10.1097/TA.0b013e3182aa811a 10.1097/SHK.0000000000000178 10.55460/SFRB-RGN9 |
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| Keywords | Compensatory reserve index Normal values Predictive algorithm Machine learning |
| Language | English |
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| References | Moulton, Mulligan, Grudic, Convertino (CR1) 2013; 75 Howard, Janak, Hinojosa-Laborde, Convertino (CR11) 2016; 46 Moulton, Mulligan, Srikiatkhachorn, Kalayanarooj, Grudic, Green (CR16) 2016; 10 Johnson, Alarhayem, Convertino, Carter, Chung, Stewart (CR12) 2017; 83 Stewart, Nawn, Mulligan, Grudic, Moulton, Convertino (CR8) 2016; 16 CR18 Hinojosa-Laborde, Howard, Mulligan, Grudic, Convertino (CR13) 2016; 310 Janak, Howard, Goei, Weber, Muniz, Hinojosa-Laborde (CR9) 2015; 44 Muraki, Hiraoka, Nagata, Nakajima, Oshita, Arimichi (CR17) 2018; 27 Elgendi (CR2) 2012; 8 Stewart, Mulligan, Grudic, Talley, Jurkovich, Moulton (CR6) 2016; 46 Gagnon, Schlader, Adams, Rivas, Mulligan, Grudic (CR14) 2016; 46 Stewart, Mulligan, Grudic, Convertino, Moulton (CR4) 2014; 77 Convertino, Howard, Hinojosa-Laborde, Cardin, Batchelder, Mulligan (CR7) 2015; 44 Johnson, Alarhayem, Convertino, Carter, Chung, Stewart (CR10) 2018; 49 Schiller, Howard, Convertino (CR3) 2017; 242 Nadler, Convertino, Gendler, Lending, Lipsky, Cardin (CR5) 2014; 42 Ehrmann, Leopold, Phillips, Shahi, Campbell, Ross (CR15) 2020; 41 SL Moulton (2725_CR1) 2013; 75 R Nadler (2725_CR5) 2014; 42 AM Schiller (2725_CR3) 2017; 242 DE Ehrmann (2725_CR15) 2020; 41 JT Howard (2725_CR11) 2016; 46 VA Convertino (2725_CR7) 2015; 44 2725_CR18 MC Johnson (2725_CR12) 2017; 83 CL Stewart (2725_CR4) 2014; 77 CL Stewart (2725_CR6) 2016; 46 D Gagnon (2725_CR14) 2016; 46 SL Moulton (2725_CR16) 2016; 10 M Elgendi (2725_CR2) 2012; 8 C Hinojosa-Laborde (2725_CR13) 2016; 310 CL Stewart (2725_CR8) 2016; 16 R Muraki (2725_CR17) 2018; 27 MC Johnson (2725_CR10) 2018; 49 JC Janak (2725_CR9) 2015; 44 |
| References_xml | – volume: 83 start-page: 603 issue: 4 year: 2017 end-page: 608 ident: CR12 article-title: Comparison of compensatory reserve and arterial lactate as markers of shock and resuscitation publication-title: J Trauma Acute Care Surg doi: 10.1097/TA.0000000000001595 – volume: 44 start-page: 548 issue: 6 year: 2015 end-page: 553 ident: CR9 article-title: Predictors of the onset of hemodynamic decompensation during progressive central hypovolemia: comparison of the peripheral perfusion index, pulse pressure variability, and compensatory reserve index publication-title: Shock doi: 10.1097/SHK.0000000000000480 – ident: CR18 – volume: 44 start-page: 27 year: 2015 end-page: 32 ident: CR7 article-title: Individual-specific, beat-to-beat trending of significant human blood loss: the compensatory reserve publication-title: Shock doi: 10.1097/SHK.0000000000000323 – volume: 41 start-page: 1190 year: 2020 ident: CR15 article-title: The compensatory reserve index responds to acute hemodynamic changes in patients with congenital heart disease: a proof of concept study publication-title: Pediatr Cardiol doi: 10.1007/s00246-020-02374-3 – volume: 242 start-page: 874 issue: 8 year: 2017 end-page: 883 ident: CR3 article-title: The physiology of blood loss and shock: new insights from a human laboratory model of hemorrhage publication-title: Exp Biol Med doi: 10.1177/1535370217694099 – volume: 49 start-page: 295 issue: 3 year: 2018 end-page: 300 ident: CR10 article-title: Compensatory reserve index: performance of a novel monitoring technology to identify the bleeding trauma patient publication-title: Shock doi: 10.1097/SHK.0000000000000959 – volume: 310 start-page: R1154 issue: 11 year: 2016 end-page: R1159 ident: CR13 article-title: Comparison of compensatory reserve during lower-body negative pressure and hemorrhage in nonhuman primates publication-title: Am J Physiol-Regul Integr Comp Physiol doi: 10.1152/ajpregu.00304.2015 – volume: 46 start-page: 61 issue: 3S year: 2016 end-page: 67 ident: CR6 article-title: The compensatory reserve index following injury: results of a prospective clinical trial publication-title: Shock doi: 10.1097/SHK.0000000000000647 – volume: 27 start-page: 802 issue: 6 year: 2018 end-page: 807 ident: CR17 article-title: Novel method for estimating the total blood volume: the importance of adjustment using the ideal body weight and age for the accurate prediction of haemodilution during cardiopulmonary bypass publication-title: Interact Cardiovasc Thorac Surg doi: 10.1093/icvts/ivy173 – volume: 46 start-page: 74 issue: 3 Suppl 1 year: 2016 end-page: 82 ident: CR14 article-title: The effect of passive heat stress and exercise-induced dehydration on the compensatory reserve during simulated hemorrhage publication-title: Shock Augusta Ga doi: 10.1097/SHK.0000000000000653 – volume: 77 start-page: 892 issue: 6 year: 2014 end-page: 898 ident: CR4 article-title: Detection of low-volume blood loss: compensatory reserve versus traditional vital signs publication-title: J Trauma Acute Care Surg doi: 10.1097/TA.0000000000000423 – volume: 16 start-page: 6 issue: 1 year: 2016 end-page: 13 ident: CR8 article-title: Compensatory reserve for early and accurate prediction of hemodynamic compromise: case studies for clinical utility in acute care and physical performance publication-title: J Spec Oper Med Peer Rev J SOF Med Prof – volume: 46 start-page: 68 issue: 3S year: 2016 end-page: 73 ident: CR11 article-title: Specificity of compensatory reserve and tissue oxygenation as early predictors of tolerance to progressive reductions in central blood volume publication-title: Shock doi: 10.1097/SHK.0000000000000632 – volume: 8 start-page: 14 issue: 1 year: 2012 end-page: 25 ident: CR2 article-title: On the analysis of fingertip photoplethysmogram signals publication-title: Curr Cardiol Rev doi: 10.2174/157340312801215782 – volume: 10 start-page: 1 issue: 1 year: 2016 end-page: 7 ident: CR16 article-title: State-of-the-art monitoring in treatment of dengue shock syndrome: a case series publication-title: J Med Case Rep doi: 10.1186/s13256-016-1019-z – volume: 75 start-page: 1053 issue: 6 year: 2013 end-page: 1059 ident: CR1 article-title: Running on empty? The compensatory reserve index publication-title: J Trauma Acute Care Surg doi: 10.1097/TA.0b013e3182aa811a – volume: 42 start-page: 93 issue: 2 year: 2014 end-page: 98 ident: CR5 article-title: The Value Of Noninvasive Measurement Of The Compensatory Reserve Index In Monitoring And Triage Of Patients Experiencing Minimal Blood Loss publication-title: Shock doi: 10.1097/SHK.0000000000000178 – volume: 10 start-page: 1 issue: 1 year: 2016 ident: 2725_CR16 publication-title: J Med Case Rep doi: 10.1186/s13256-016-1019-z – volume: 77 start-page: 892 issue: 6 year: 2014 ident: 2725_CR4 publication-title: J Trauma Acute Care Surg doi: 10.1097/TA.0000000000000423 – volume: 49 start-page: 295 issue: 3 year: 2018 ident: 2725_CR10 publication-title: Shock doi: 10.1097/SHK.0000000000000959 – volume: 46 start-page: 68 issue: 3S year: 2016 ident: 2725_CR11 publication-title: Shock doi: 10.1097/SHK.0000000000000632 – volume: 8 start-page: 14 issue: 1 year: 2012 ident: 2725_CR2 publication-title: Curr Cardiol Rev doi: 10.2174/157340312801215782 – volume: 46 start-page: 61 issue: 3S year: 2016 ident: 2725_CR6 publication-title: Shock doi: 10.1097/SHK.0000000000000647 – volume: 44 start-page: 27 year: 2015 ident: 2725_CR7 publication-title: Shock doi: 10.1097/SHK.0000000000000323 – volume: 27 start-page: 802 issue: 6 year: 2018 ident: 2725_CR17 publication-title: Interact Cardiovasc Thorac Surg doi: 10.1093/icvts/ivy173 – ident: 2725_CR18 – volume: 242 start-page: 874 issue: 8 year: 2017 ident: 2725_CR3 publication-title: Exp Biol Med doi: 10.1177/1535370217694099 – volume: 44 start-page: 548 issue: 6 year: 2015 ident: 2725_CR9 publication-title: Shock doi: 10.1097/SHK.0000000000000480 – volume: 46 start-page: 74 issue: 3 Suppl 1 year: 2016 ident: 2725_CR14 publication-title: Shock Augusta Ga doi: 10.1097/SHK.0000000000000653 – volume: 16 start-page: 6 issue: 1 year: 2016 ident: 2725_CR8 publication-title: J Spec Oper Med Peer Rev J SOF Med Prof doi: 10.55460/SFRB-RGN9 – volume: 310 start-page: R1154 issue: 11 year: 2016 ident: 2725_CR13 publication-title: Am J Physiol-Regul Integr Comp Physiol doi: 10.1152/ajpregu.00304.2015 – volume: 41 start-page: 1190 year: 2020 ident: 2725_CR15 publication-title: Pediatr Cardiol doi: 10.1007/s00246-020-02374-3 – volume: 42 start-page: 93 issue: 2 year: 2014 ident: 2725_CR5 publication-title: Shock doi: 10.1097/SHK.0000000000000178 – volume: 83 start-page: 603 issue: 4 year: 2017 ident: 2725_CR12 publication-title: J Trauma Acute Care Surg doi: 10.1097/TA.0000000000001595 – volume: 75 start-page: 1053 issue: 6 year: 2013 ident: 2725_CR1 publication-title: J Trauma Acute Care Surg doi: 10.1097/TA.0b013e3182aa811a |
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| SubjectTerms | Adolescent Adult Blood Pressure - physiology Blood Volume - physiology Cardiac Surgery Cardiology Child Children Data entry Health aspects Heart beat Heart Rate - physiology Hemodynamics - physiology Humans Medicine Medicine & Public Health Original Article Pediatrics Vascular Surgery Vital Signs - physiology |
| Title | Baseline Values of the Compensatory Reserve Index in a Healthy Pediatric Population |
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