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  BVA-100: Indications

 
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The following is a partial list of medical and surgical conditions where blood volume abnormalities occur.

Acute blood loss during surgery or trauma

Four million patients receive blood transfusions annually. The standard surrogate tests measure the thickness of the blood and not the blood volume. A patient may receive an unnecessary transfusion. A much more common problem is that a transfusion may be withheld because the extent of blood loss has not been recognized. Severe organ damage may occur from low blood volume. A significant number of patients with no kidney disease may develop kidney failure as a complication of inadequate or delayed transfusion. Physicians are faced with a difficult choice of administering a transfusion that may cause infection or other complications, or withholding a transfusion from a patient who may suffer complications from low blood volume.

Hypertension

There are more than 50 million Americans with hypertension (i.e., high blood pressure). Seventy percent are reported to be inadequately treated. Hypertension is caused by one of two variables: excess blood volume or excess vasoconstriction. Vasoconstriction is an excessive tightening of the blood vessels. Hypertension is treated with two types of medications, vasodilators, which relax the blood vessels, or diuretics, which cause the kidney to lose fluid and decrease blood volume. Presently, neither variable is measured. Treating high blood pressure is a trial and error process of choosing from more than fifty drugs currently approved for hypertension therapy. Some patients with hypertension have expanded blood volume (i.e., hypervolemia) and should be given diuretics. However, some hypertensive patients may actually have a decreased blood volume. Giving such a patient a diuretic decreases the blood flow to the kidney, and may cause damage. The kidneys are particularly susceptible to decreased blood flow problems, with complete renal failure being a dreaded complication of hypertension.

Syncope

Syncope is a condition of fainting or sudden total loss of consciousness. The Cleveland Clinic, which has the number one Cardiovascular Department in the United States, is now routinely measuring blood volume with the BVA-100 in its Syncope Department. A blood volume measurement can help define the problem so that proper treatment may be provided. Syncope can be caused by fundamentally different problems. A blood volume measurement is essential to help define whether the problem is caused by low blood volume. The availability of blood volume measurements provides an essential tool for proper diagnosis and treatment.

Orthostatic hypotension

Orthostatic hypertension is a condition whereby a sharp drop in blood pressure occurs when an individual arises from a sitting or lying position. Reports have indicated that one third of elderly patients have this condition. Orthosatic hypotension may be associated with low blood volume or disturbances in blood pressure control. Some patients may experience syncope, or a total loss of consciousness. Patients who have orthostatic hypotension have an increased chance of falling, which predisposes to a hip fracture. Blood volume measurements can lead to effective preventive therapy.

Congestive heart failure

Five million patients are treated annually for congestive heart failure. This condition is usually associated with an expanded blood volume. Treatment is aimed at normalizing a patient's blood volume. Overtreatment can be just as damaging as undertreatment. The Heart Failure Center at Presbyterian New York Hospital is utilizing a BVA-100.

Septic shock and hypovolemia

More than 100,000 patients die annually from septic shock. Of the patients suffering from this condition, 45-70% of them die. This is a condition where there is a collapse of blood pressure and unless quickly reversed, results in a high mortality rate. The Lutheran Medical Center recently reported a 20% lower death rate in patients with septic shock when the BVA-100 was used for treatment decisions to detect low blood volume.

Anemia in cancer patients or HIV positive patients on chemotherapy

Such patients commonly develop decreased red blood cell production and symptoms. Standard tests may not reveal the extent or severity of the problem. A blood volume measurement can provide specific information about the extent of red cell depletion. Epogen and Procrit are accepted treatments for red cell depletion.

Renal or kidney failure

There are 500,000 patients in kidney failure, with over 250,000 on renal dialysis treatments. Patients on renal dialysis treatment have major changes in their blood volume during their treatment. These patients also suffer from severe anemia requiring injections to stimulate their blood production. Such patients have a 41% mortality rate from an initial heart attack. Blood volume measurement in such patients can provide essential information for patient care, to avoid complications.

Preoperative screening for low blood volume

With regard to avoiding blood transfusions for hypovolemia with particular emphasis on women, women have been shown to require more transfusions and have a higher incidence of complications from cardiac bypass surgery. By utilizing a Blood Volume Analyzer it is possible to screen both men and women pre-operatively for low blood volume in elective surgical situations. Patients found to have low blood volume can be treated with medication to build up their blood volume to normal prior to surgery. Patients who have a normal blood volume at the onset of surgery are less likely to require transfusion and less likely to have inadequate blood flow to the brain. Avoidance of brain damage should be a central focus of all surgical planning.

Chronic fatigue syndrome

One million Americans are reported to suffer from chronic fatigue syndrome. Low blood volume has been reported as a factor in this condition. Preliminary studies have shown that some patients with this condition do have low blood volume and can benefit from treatment. A blood volume measurement can help distinguish these patients from patients whose symptoms are unrelated to blood volume abnormalities.

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