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以及他们在这些情况下感知的“输血可能性”的评估。专家麻醉师接受了有关临床线索的问卷调查,形式是对理论患者的诊断。他们被要求使用100 mm视觉模拟量表(VAS)评估每个患者的心脏储备和这些患者的“输血可能性”。 VAS的端点分别为“非常低”(0毫米)至“高”(100毫米)和“请勿输液”(0毫米)至“输液”(100毫米)。麻醉师对患者心输出量储备的评估(n = 54)显示出很大的差异。例如,总的来说,严重的主动脉瓣狭窄患者的心输出量增加能力有限(平均VAS 16毫米),但是麻醉师之间的差异很大(10毫米至21毫米为25-75%)。对“输血可能性”的评估(n = 42)也有很大差异。例如,患有“心绞痛”且血红蛋白为95 g l(-1)的患者总体上被认为平均输血的可能性为50 mm,但25-75%的范围为33 mm至71 mm。这项研究表明,麻醉师之间在评估患者的“心输出量储备”和“输血可能性”方面存在很大差异。

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