Does central venous pressure or pulmonary capillary wedge pressure reflect the status of circulating blood volume in patients after extended transthoracic esophagectomy?
Does central venous pressure or pulmonary capillary wedge pressure reflect the status of circulating blood volume in patients after extended transthoracic esophagectomy?
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DOI：
10.1007/s00540-004-0282-0
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发表时间：
2005-01-01
影响因子：
2.8
通讯作者：
Endoh, Hiroshi
中科院分区：
文献类型：
--
作者：
Oohashi, Satomi;Endoh, Hiroshi
目得：为探讨中心静脉压（CVP）或肺毛细血管楔压（PCWP）能否准确反映成人食管癌扩大切除术围手术期循环血容量（CBV）的状况，对16例成人食管癌扩大切除术患者在以下7个时点同时测定CVP、PCWP和CBV：基线（手术前）和入住重症监护室（ICU）后0、12、24、36、48和60 h。CBV在床旁用吲哚菁绿色脉冲染料光密度法估计。结果：共获得122个配对数据。CBV的平均值在进入ICU时下降约-20%，在手术后48小时增加约24%。CVP和PCWP的时间过程与CBV相似：均在进入ICU时下降，然后逐渐增加，并在术后48 h达到峰值。然而，两种压力均保持在正常范围内，相对于基线的实际变化很小。CBV与CVP（r = 0.17，P = 0.07）、CBV与PCWP（r = 0.03，P = 0.78）之间无显著相关性。结论：CVP和PCWP均不能准确反映成人食管癌扩大切除术后CBV的状态。
PURPOSE: We investigated whether central venous pressure (CVP) or pulmonary capillary wedge pressure (PCWP) can accurately reflect the status of circulating blood volume (CBV) during the perioperative period in adult patients after extended transthoracic esophagectomy.METHODS: In 16 adult patients undergoing esophagectomy, simultaneous measurements of CVP, PCWP, and CBV were made at the following seven points: baseline (before surgery) and at 0, 12, 24, 36, 48, and 60 h after admission to the intensive care unit (ICU). CBV was estimated at the bedside with a pulse-dye densitometry method using indocyanine green. The relationship between CBV and these filling pressures was analyzed by linear regression.RESULTS: A total of 122 paired observations were made. The mean value of CBV decreased by approximately -20% at admission to the ICU and increased by approximately 24% of baseline at 48 h after surgery. The time course of CVP and PCWP was similar to that of CBV: both decreased at admission to the ICU, then gradually increased, and peaked at 48 h after surgery. However, both pressures remained within normal ranges, and the actual changes from baseline were small. There was no significant relationship between CBV and CVP (r = 0.17, P = 0.07), and between CBV and PCWP (r = 0.03, P = 0.78).CONCLUSION: Neither CVP nor PCWP accurately reflected the status of CBV in adult patients after extended transthoracic esophagectomy.