Blood volume measurements as a support tool for clinical assessments hold great potential

For the Nephrology specialty, blood volume measurement is used in clinical practice as a supplementary tool for medical assessment and decision-making. It functions as a support tool that can contribute objective data, but it does not replace clinical judgment. An important point is that the measurement should not lead to overtreatment – rather, it should help to nuance and clarify the need for treatment. Although the technology is useful, it has not removed all uncertainty in the decision-making process. In practice, the results are often only available after key decisions have already been made, which can limit the immediate usefulness of the measurement in acute situations. So far, blood volume measurement has mainly been used in connection with outpatient visits, and it has therefore not had a significant influence on the actual hospitalization process or the more acute treatment choices.

Regarding the potential of blood volume measurement, there is a particular focus on patients with renal failure and on the dosing of erythropoietin (EPO). Here, the method is considered to play an important role, as an accurate assessment of plasma volume and red blood cell volume can contribute to better individualized treatment. However, experience in this area is still limited, and there is a need for more systematic data collection and exchange of experience.

There is significant development potential, especially in research and in connection with the treatment of hemodialysis patients. This patient group can greatly benefit from measurements that provide insight into fluid status and blood volume, which can support both treatment planning and monitoring over time.

Based on the preliminary experience, it is recommended that blood volume measurement continues to be available in the clinic. However, a more systematic setup around the use of the measurement would be desirable – both in terms of interpretation, implementation and data management. A more structured and uniform setup would strengthen the clinical value of the method and ensure that it is used in a targeted and effective way for the patients who benefit
most from it. Overall, blood volume measurement has clear potential, but it requires a more integrated approach and a closer link to the clinical decision-making process to unfold its full value.

For the cardiology specialty, blood volume measurement has the potential to play an important role in treatment planning and decision-making, especially in situations where there is diagnostic uncertainty. This may be the case, for example, when heart failure is suspected, where it may be difficult to assess whether the patient’s symptoms are due to fluid retention or other causes. In such situations, the measurement can be crucial in confirming or denying a fluid balance disorder. In this way, the technology can help to manage treatment more precisely – both in terms of deciding whether an initiated treatment should be continued, adjusted or possibly terminated. The technology thus holds significant potential for reducing clinical uncertainty and thus supporting more targeted and effective patient treatment.

When it comes to implementation in clinical practice, it is important to emphasize that blood volume measurement should not replace medical judgment. On the contrary, the technology should be considered as a supplement to clinical judgment – a tool that can especially support junior doctors during rounds, where decisions often have to be made quickly and under pressure. However, the method should not be used uncritically, and clinicians should not rely on the measurement without sufficient consideration of the overall clinical picture. It is therefore crucial that blood volume measurement is used with care and in the right context.

The measurement should be used especially in selected patient groups where it is difficult to assess the condition with conventional methods. This applies, for example, to patients with severe heart failure or other complex conditions where fluid status is difficult to assess clinically. Here, the measurement can provide important knowledge that supports a more differentiated treatment strategy. On the other hand, blood volume measurement should not become a standard tool that is routinely used for all patients. Its strength lies precisely in its targeted use in situations where clinical assessment alone is not sufficient. A selective and well-considered use of the technology will therefore be the key to achieving the greatest possible clinical effect without compromising medical expertise.