The aim of this pilot study was to investigate anaesthetists' assessment of the ability of patients to increase cardiac output over a range of clinical scenarios and of their perceived 'likelihood of transfusion' in these scenarios. Specialist anaesthetists were given a questionnaire with clinical cues in the form of diagnoses about theoretical patients. They were asked to use 100 mm visual analogue scales (VAS) for their assessments of each patient's cardiac reserve and their 'likelihood of transfusion' of these patients; the endpoints of the VAS being 'Very low' (0 mm) to 'High' (100 mm), and 'Do not transfuse' (0 mm) to 'Transfuse' (100 mm) respectively. The assessment of patients' cardiac output reserve by anaesthetists (n = 54) showed great variation; for example, a patient with severe aortic stenosis was perceived overall to have a limited ability to increase cardiac output (mean VAS 16 mm) but there was considerable variation between anaesthetists (25-75 percentiles 10 mm to 21 mm). Assessment of 'likelihood of transfusion' (n = 42) also had great variation; as an example a patient with 'angina' with a haemoglobin of 95 g l(-1) was perceived overall to have an average likelihood of transfusion of 50 mm, but the 25-75 percentiles ranged from 33 mm to 71 mm. This study suggests that inter-anaesthetist variability in the assessment of a patient's 'cardiac output reserve' and his 'likelihood of transfusion' is large.

译文

这项初步研究的目的是调查麻醉师对患者在一系列临床情况下增加心输出量的能力的评估,以及他们在这些情况下感知到的 “输血可能性”。以理论患者的诊断形式向专科麻醉师提供了一份带有临床线索的问卷。他们被要求使用100毫米视觉模拟量表 (VAS) 来评估每个患者的心脏储备和这些患者的 “输血可能性”; VAS的终点是 “非常低” (0毫米) 到 “高” (100毫米),和 “不输血” (0毫米) 分别转换为 “输血” (100毫米)。麻醉师 (n = 54) 对患者心输出量储备的评估显示出很大的差异; 例如,总体上认为患有严重主动脉瓣狭窄的患者增加心输出量的能力有限 (平均VAS 16毫米),但麻醉师之间存在相当大的差异 (25-75个百分位数10毫米至21毫米)。“输血可能性” 的评估 (n = 42) 也有很大的差异; 例如,具有95g l(-1) 血红蛋白的 “angina” 患者总体上被认为平均输血可能性为50毫米,但25-75个百分位数范围为33毫米至71毫米。这项研究表明,在评估患者的 “心输出量储备” 和他的 “输血可能性” 时,麻醉师间的变异性很大。

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