Lithium dilution measurement of cardiac output and arterial pulse waveform analysis: an indicator dilution calibrated beat-by-beat system for continuous estimation of cardiac output.
Lithium dilution measurement of cardiac output and arterial pulse waveform analysis: an indicator dilution calibrated beat-by-beat system for continuous estimation of cardiac output.
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DOI：
10.1097/00075198-200206000-00010
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发表时间：
2002-06-01
影响因子：
3.3
通讯作者：
Tanser, Suzie J
中科院分区：
文献类型：
--
作者：
Jonas, Max M;Tanser, Suzie J
锂稀释心输出量（LiDCO商标; LiDCO，伦敦，英国）是用于测量心输出量的微创指示剂稀释技术。它主要是作为PulseCO商标（LiDCO，伦敦，英国）连续动脉波形分析监护仪的简单校准而开发的。该技术是快速和简单的，只需要一个动脉线和中心或外周静脉通路。这些线路可能已经被插入重症监护患者。小剂量的氯化锂作为静脉推注注射，心输出量由连接到动脉线的锂敏感电极产生的稀释曲线导出。在人类和动物中的研究表明，与其他技术获得的结果相比，LiDCO商标在儿科患者中的疗效也得到了证明。与热稀释法相比，锂稀释法在临床研究中显示出与电磁流量测量更接近的一致性。PulseCO商标是一种逐搏心输出量监测仪，使用自相关算法从动脉压波形计算每搏输出量。该算法不依赖于波形形态，而是根据整个波形的压力-容积变换计算标称每搏输出量。通过使用LiDCO商标对算法进行校准，将标称冲程容积转换为实际冲程容积。最初的研究表明，良好的保真度，在美国和英国的中心的结果是非常令人鼓舞的。PulseCO商标监护仪包含用于解释生成的血流动力学数据的软件，并提供动脉压变化（即每搏输出量变化、脉压变化和收缩压变化）的实时分析，作为血管内和心脏充盈的理论指南。
Lithium dilution cardiac output (LiDCO trade mark; LiDCO, London, UK) is a minimally invasive indicator dilution technique for the measurement of cardiac output. It was primarily developed as a simple calibration for the PulseCO trade mark (LiDCO, London, UK) continuous arterial waveform analysis monitor. The technique is quick and simple, requiring only an arterial line and central or peripheral venous access. These lines would probably already have been inserted in critical care patients. A small dose of lithium chloride is injected as an intravenous bolus, and cardiac output is derived from the dilution curve generated by a lithium-sensitive electrode attached to the arterial line. Studies in humans and animals have shown good agreement compared with results obtained with other techniques, and the efficacy of LiDCO trade mark in pediatric patients has also been proven. Compared with thermodilution, lithium dilution showed closer agreement in clinical studies with electromagnetic flow measurement.PulseCO trade mark is a beat-to-beat cardiac output monitor that calculates stroke volume from the arterial pressure waveform using an autocorrelation algorithm. The algorithm is not dependent on waveform morphology, but, rather, it calculates nominal stroke volume from a pressure-volume transform of the entire waveform. The nominal stroke volume is converted to actual stroke volume by calibration of the algorithm with LiDCO trade mark. Initial studies indicate good fidelity, and the results from centers in the United States and the United Kingdom are extremely encouraging. The PulseCO trade mark monitor incorporates software for interpretation of the hemodynamic data generated and provides a real-time analysis of arterial pressure variations (ie, stroke volume variation, pulse pressure variation, and systolic pressure variation) as theoretical guides to intravascular and cardiac filling.