Ng can be a precious program. Placement of catheters can easily be performed and is even in unstable patients practicable.Available online http://ccforum.com/supplements/5/SP152 Pulse oximeter waveform analysis as a measure of circulatory statusPM Middleton, A Retter, JA Henry Division of Academic Accident Emergency Paeonol Medicine, Imperial College College of Medicine, St Mary’s Hospital, Praed Street, London W2 1NY, UK The pulse oximeter waveform (POW) is derived from variation in intensity of transmitted light through tissues. It may be made use of to supply a non-invasive surrogate for the intra-arterial waveform, and represents an accessible measure of cardiovascular status. We examined the effects of age, blood pressure and smoking on the waveform patterns. These factors are identified to reduce arterial compliance, raise peripheral wave reflection and alter the contour on the pulse stress waveform. Supine and standing POW recordings were taken from 200 healthier volunteers. The resting waveform patterns had been categorised into four distinct classes as described by Murgo and Nichols for intra-arterial stress waveforms, and compared to age and systolic blood pressure. Post hoc ANOVA revealed a significant relationship involving waveform class and age (P < 0.001), blood pressure (P < 0.001), and smoking status (P = 0.021. These effects appear to represent changes in the peripheral arterial system resulting from altered wave reflection. We also analysed the POW in both time and frequency domains. On standing, time domain analysis showed a decrease in total variability, as measured by standard deviation and variance. Frequency domain analysis demonstrated an increase in power at a frequency (0.1 Hz) associated with sympathetic nervous system output. These results are consistent with changes in the microcirculation related to autonomic control mechanisms. These patterns of change, however, were only apparent in a proportion PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 of your subjects. We believe that the responses elicited are dependent on variables affecting the long-term compliance with the arterial tree, and are therefore connected to the pulse oximeter waveform classification described. We’ve got shown that POW analysis yields consistent and reproducible patterns. Further research may perhaps result in the use of these approaches as a measure of peripheral vascular responsiveness, with possible utility within the evaluation of cardiovascular illness.P153 Optimistic correlation involving daily changes of initial distribution volume of glucose and cardiac output following subtotalesophagectomyH Okawa, H Ishihara, T Iwakawa, T Tsubo, A Matsuki Intensive Care Unit and Division of Anesthesiology, University of Hirosaki College of Medicine, five Zaifu-cho, Hirosaki, Aomori, Japan Introduction: We have reported that the initial distribution volume of glucose (IDVG) reflects the central extracellular fluid volume status and correlated with cardiac output following important surgery. In clinical practice we are working with IDVG as an indicator of cardiac preload to predict hypovolemia or fluid refilling phase following main surgery. IDVG is definitely an intermittent measurement parameter and its rather time consuming process limits frequent measurements of IDVG. In this study, to investigate irrespective of whether or not continuous cardiac output (CO) monitoring could possibly be employed as a clinical alternative of IDVG to estimate the modifications in cardiac preload, we examined a correlation among changes in CO and IDVG in sedated, mechanically ventilated postoperative patien.