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Comparative Study
. 2018 Sep;24(9):553-560.
doi: 10.1016/j.cardfail.2018.07.462. Epub 2018 Aug 8.

Calculated Estimates of Plasma Volume in Patients With Chronic Heart Failure-Comparison With Measured Volumes

Marat Fudim  1 , Wayne L Miller  2
Affiliations
Comparative Study

Calculated Estimates of Plasma Volume in Patients With Chronic Heart Failure-Comparison With Measured Volumes

Marat Fudim et al. J Card Fail. 2018 Sep.

Abstract

Background: Calculated estimates of plasma volume (PV) have been developed with the use of hemoglobin/hematocrit-body weight-based methods. The accuracy of such formula-derived values has not been thoroughly evaluated. The objective of this analysis was to compare the calculated estimate and a quantitative measure of PV in patients with chronic heart failure (HF).

Methods and results: PV was measured with the use of a standardized computer-based indicator-dilution-labeled albumin technique in 110 patients with clinically stable chronic HF and correlated with paired Kaplan-Hakim (K-H) and Strauss formula estimates of PV. The K-H formula underestimated (3.4 ± 0.7 L) and the Strauss formula overestimated (5.3 ± 1.5 L) PV relative to the measured volume (4.3 ± 1.1 L). Calculated PV was only moderately correlated with measured PV by the K-H formula (r = 0.64; P < .001) and weakly by the Strauss formula (r = 0.285; P = .003). Strauss formula estimates of change (%) in PV were also poorly correlated with paired measured changes in PV (r = 0.162; P = .999; n = 40).

Conclusions: Calculated estimates of PV demonstrate limited association with measured volumes. These findings indicate that although formula-based estimates of PV have been shown to have prognostic value, they are limited in their reliability for volume management in patients with chronic HF.

Keywords: Formula estimated plasma volume; chronic heart failure; measured plasma volume.

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Conflict of interest statement

Conflicts of Interest

None.

Figures

Figure 1.
Figure 1.
Relationship of Formula Estimated (Kaplan-Hakim) to Measured Plasma Volume in a Cohort of Patients with Chronic Heart Failure (N=110). Agreement of plasma volume methods: Spearman’s correlation (A) and Bland-Altman Plot (B).
Figure 1.
Figure 1.
Relationship of Formula Estimated (Kaplan-Hakim) to Measured Plasma Volume in a Cohort of Patients with Chronic Heart Failure (N=110). Agreement of plasma volume methods: Spearman’s correlation (A) and Bland-Altman Plot (B).
Figure 2.
Figure 2.
Relationship of Formula Estimated (Strauss) to Measured Plasma Volume in a Cohort of Patients Chronic Heart Failure (N=110). Agreement of plasma volume methods: Spearman’s correlation (A) and Bland-Altman Plot (B).
Figure 2.
Figure 2.
Relationship of Formula Estimated (Strauss) to Measured Plasma Volume in a Cohort of Patients Chronic Heart Failure (N=110). Agreement of plasma volume methods: Spearman’s correlation (A) and Bland-Altman Plot (B).
Figure 3.
Figure 3.
Relationship of Kaplan-Hakim Formula Calculated to Measured Plasma Volume Expressed as Percent Deviation from Normal Expected Plasma Volume in a Cohort of Patients with Chronic Heart Failure (N=110).
Figure 4.
Figure 4.
Strauss Formula Calculated Percent Change in Plasma Volume vs. Measured Percent Change in Plasma Volume Hospital Admission to Discharge in Patients with Chronic Heart Failure (N=40).
Figure 5.
Figure 5.
Relationship of Absolute Change in Venous Hemoglobin (g/dL) to Change in Measured Plasma Volume (mL) Hospital Admission to Discharge in Patients with Chronic Heart Failure (N=40).
See this image and copyright information in PMC

Comment in

References

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