INTRATHORACIC BLOOD-VOLUME ACCURATELY REFLECTS CIRCULATORY VOLUME STATUS IN CRITICALLY ILL PATIENTS WITH MECHANICAL VENTILATION
INTRATHORACIC BLOOD-VOLUME ACCURATELY REFLECTS CIRCULATORY VOLUME STATUS IN CRITICALLY ILL PATIENTS WITH MECHANICAL VENTILATION
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DOI：
10.1007/bf01709237
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发表时间：
1992-06-01
影响因子：
38.9
通讯作者：
PFEIFFER, UJ
中科院分区：
文献类型：
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作者：
LICHTWARCKASCHOFF, M;ZERAVIK, J;PFEIFFER, UJ
急性呼吸衰竭（ARF）患者的正压通气可能导致难以将中心静脉压（CVP）或肺楔压（PCWP）解释为循环容量的指标。心脏前负荷分量（CI）和卒中指数（SI）也受到正压通气增加的胸内压的影响。此外，CI和SI不仅指示容量状态，还指示收缩性和后负荷。我们研究了胸内血容量（ITBV）是否更准确地反映了血容量状态和由此产生的氧转运（DO 2）。测定21例ARF患者的CVP、PCWP、心搏指数（CI）、心搏指数（SI），计算氧转运指数（DO_2I）和氧耗指数（VO_2I）。必要时调整通气模式。用5 F光纤热敏电阻股动脉导管测得热染料稀释曲线，输入热染料计算机，计算CI、SI和胸内血容量指数（ITBVI）。所有数据均以6 h为间隔收集。共获得224个数据集。在绝对值之间以及6小时变化之间进行线性回归分析（前缀-DELTA）。测定了以下相关系数：CVP/CI和PCWP/CI 0.01和-0.142（p
Positive pressure ventilation in patients with acute respiratory failure (ARF) may render the interpretation of central venous pressure (CVP) or pulmonary wedge pressure (PCWP) difficult as indicators of circulating volume. The preload component of cardiac (CI) and stroke index (SI) is also influenced by the increased intrathoracic pressures of positive pressure ventilation. Moreover CI and SI do not indicate volume status exclusively but also contractility and afterload. We investigated whether intrathoracic blood volume (ITBV) more accurately reflects blood volume status and the resulting oxygen transport (DO2). CVP, PCWP, cardiac (CI) and stroke index (SI) were measured, oxygen transport index (DO2I) and oxygen consumption index (VO2I) were calculated in 21 ARF-patients. Ventilatory patterns were adjusted as necessary. CI, SI and intrathoracic blood volume index (ITBVI) were derived from thermal dye dilution curves which were detected with a 5 F fiberoptic thermistor femoral artery catheter and fed into a thermal-dye-computer. All data were collected in intervals of 6 h. There were 224 data sets obtained. Linear regression analysis was performed between absolute values as well as between the 6 h changes (prefix-DELTA). The following correlation coefficients were determined: CVP/CI and PCWP/CI 0.01 and -0.142(p