The following is a partial list of medical and
surgical conditions where blood volume abnormalities occur.
Acute blood loss
during surgery or trauma
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.
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 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.
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
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
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
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
Renal or kidney
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
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.
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.