Cardiac output measurement by transpulmonary versus conventional thermodilution technique in intensive care patients after coronary artery bypass grafting
Cardiac output measurement by transpulmonary versus conventional thermodilution technique in intensive care patients after coronary artery bypass grafting
复制标题
DOI：
10.1016/s1053-0770(98)90093-3
复制
发表时间：
1998-10-01
影响因子：
2.8
通讯作者：
Martin, E
中科院分区：
文献类型：
--
作者：
Gust, R;Gottschalk, A;Martin, E
目的：本研究的目的是评价经肺热稀释法测定心输出量（CO）的相关性、准确性和精密度。为此，将该技术与临床金标准进行比较，即冠状动脉旁路移植术（CABG）后患者通过肺动脉导管测量CO。设计：前瞻性临床研究。设置：大学医学中心。参与者：CABG后重症监护室（ICU）的75名患者。干预措施：通过中心静脉注射冷却的盐水溶液，同时进行标准（SCO）和经硫酸热稀释CO测量（TPCO），一式三份。所有的变量记录在五个不同的时间点的测量过程中脱机机械ventilation.Measurements和主要结果：CO测量产生了375个数据对。SCO范围从2.0到10.2 L/min，和TPCO从1.3到10.6 L/min。在整个观察期间，TPCO测量往往产生相对较高的值，而SCO测量导致较低的值。TPCO和SCO测量值之间的相关性显著（r = 0.73; p < 0.05），准确度为0.456 L/min（7.3%），精度为1.156 L/min（18.5%）。在大多数患者中，TPCO测量不会取代肺动脉导管的传统技术，但在某些患者中，它提供了一种有吸引力的，可靠和安全的方法来确定CO。版权所有（C）1998年由W.B.桑德斯公司
Objective: The aim of the present study was to evaluate the correlation, accuracy, and precision of transpulmonary thermodilution cardiac output (CO) measurement. For this purpose, this technique was compared with the clinical gold standard, the CO measurement by pulmonary artery catheter in patients after coronary artery bypass grafting (CABG).Design: A prospective clinical study.Setting: A university medical center.Participants: Seventy-five patients in an intensive care unit (ICU) after CABG.Interventions: Standard (SCO) and transpulmonary thermodilution CO measurement (TPCO) measurements were simultaneously performed in triplicate by central venous injection of cooled saline solution. AII variables were recorded at five different time points of measurement during weaning from mechanical ventilation.Measurements and Main Results: CO measurements yielded 375 data pairs. SCO ranged from 2.0 to 10.2 L/min, and TPCO from 1.3 to 10.6 L/min. During the entire observation period, TPCO measurements tended to yield relatively high values, whereas SCO measurements resulted in lower values. Correlation between TPCO and SCO measurements was significant (r = 0.73; p < 0.05), accompanied by an accuracy with a bias of 0.456 L/min (7.3%) and a precision of 1.156 L/min (18.5%).Conclusion: In most patients, TPCO measurement will not replace the conventional technique by pulmonary artery catheter, but in some patients it offers an attractive, reliable, and safe method to determine CO. Copyright (C) 1998 by W.B. Saunders Company.