Evidence map›Paper›PMID 40532359›Full record

Observational studyJournal of clinical anesthesia2025

A prospective, observational study of non-invasive venous waveform analysis (NIVA) for the detection of acute low volume blood loss in humans.

Bret D Alvis, Dawson Wervey, Romy Pein, Eric Wise, Jenna Sobey, Annmarie Mede, Lexie Vaughn, Marisa Case, Meghan Breed, Jain Priyanka and 3 more

Abstract readObservational Study
In one paragraph

Observational study in Journal of clinical anesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Bret D AlvisDepartment of Anesthesiology, Vanderbilt University Medical Center, 422 MAB, 1211 21(st) Ave South, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235, USA. Electronic address: bret.d.alvis@vumc.org.
Dawson WerveyOhio University Heritage College of Osteopathic Medicine, 191 W. Union St., Athens, OH 45701, USA. Electronic address: dw093522@ohio.edu.
Romy PeinNew York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595, USA. Electronic address: rpein@student.nymc.edu.
Eric WiseDepartment of Surgery, University of Minnesota Medical Center, 420 Delware St SE, Minneapolis, MN 55455, USA. Electronic address: wise0147@umn.edu.
Jenna SobeyDepartment of Anesthesiology, Vanderbilt University Medical Center, 422 MAB, 1211 21(st) Ave South, Nashville, TN 37232, USA.
Annmarie MedeUniversity of California San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, USA. Electronic address: annmarie.i.mede@ucsf.edu.
Lexie VaughnUniversity of Arkansas Medical Sciences Medical Center, Little Rock, 4301 W Markham St, AR 72205, USA.
Marisa CaseDepartment of Anesthesiology, Vanderbilt University Medical Center, 422 MAB, 1211 21(st) Ave South, Nashville, TN 37232, USA. Electronic address: marisa.case@vumc.org.
Meghan BreedMedStar Health, 110 Irving St NW, Washington, DC 20010, USA.
Jain PriyankaUniversity of New Mexico School of Medicine, 2501 Frontier Ave NE, Albuquerque, NM 87106, USA. Electronic address: prjain@salud.unm.edu.
Philip LeisyDepartment of Anesthesiology, Vanderbilt University Medical Center, 422 MAB, 1211 21(st) Ave South, Nashville, TN 37232, USA. Electronic address: philip.j.leisy@vumc.org.
Colleen BrophyDepartment of Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA. Electronic address: colleen.brophy@vumc.org.
Kyle HockingDepartment of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235, USA; Department of Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA. Electronic address: kyle.m.hocking@vumc.org.

Funding

Venous Waveform Analysis to Predict Volume OverloadR01HL148244 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Bret D. Alvis · 2019 to 2026
$3.4M
NHLBI NIH HHS R01 HL148244NIAID NIH HHS L30 AI154576
6 · The paper itself

Abstract

backgroundAccurate non-invasive monitoring for the diagnosis of hemorrhage is an unmet need in acute care settings. Non-Invasive Venous waveform Analysis (NIVA) has demonstrated significant sensitivity in detecting acute hemorrhage with 8-10 % blood volume loss. To determine whether NIVA can accurately and non-invasively detect lower volumes of blood loss, we performed a prospective observational study using a digital blood volume monitor at an American Red Cross (ARC) donation center to assess NIVA's performance at lower blood volume loss.

methodsVenous waveforms were successfully captured in 33 ARC-approved patients. Waveforms were recorded for the duration of whole blood donation and then transformed from the time domain to the frequency domain. The ratiometric power contribution of the cardiac frequencies was used to calculate a representative volume status value, the IntraVAscular Number (IVAN).

resultsA significant decrease in the IVAN output was observed after just 200 mL (3-4 % blood volume) of whole blood donation (p < 0.05). The ROC curve demonstrated an Area Under the Curve (AUC) of 0.65 for the ability of delta IVAN to detect 200 mL of blood loss. The Receiver Operating Characteristic (ROC) curve demonstrated an AUC of 0.91 for the ability of delta IVAN to detect 500 mL of blood loss.

conclusionThere remains a large unmet need for accurate and timely detection of acute hemorrhage. This study supports the potential application of NIVA in the detection of acute low-volume human blood loss. NIVA is a novel technology that uses previously undetectable low-amplitude venous signals of the cardiac pulse, which may prove useful for more accurate and early detection of acute hemorrhage.

Indexed as

HemorrhageAcute DiseaseAdultAgedBlood VolumeFemaleHumansMaleMiddle AgedProspective StudiesROC CurveBlood lossHemodynamicsHemorrhageMonitoringVenousWaveforms

Identifiers

PMID40532359
PMCPMC12814903

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.