Transpulmonary thermodilution-derived cardiac function index identifies cardiac dysfunction in acute heart failure and septic patients: an observational study.
Transpulmonary thermodilution-derived cardiac function index identifies cardiac dysfunction in acute heart failure and septic patients: an observational study.
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DOI：
10.1186/cc7994
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Maggiorini M
中科院分区：
文献类型：
--
作者：
Ritter S;Rudiger A;Maggiorini M
单指示剂经肺热稀释（脉搏轮廓心输出量，或PiCCO）技术在重症医学患者中的临床经验有限，特别是在急性心力衰竭（AHF）患者中。因此，我们比较了使用肺动脉导管（PAC）和PiCCO技术的AHF或脓毒症患者的心功能。这项回顾性观察性研究是在一所大学医院的重症监护室进行的。在24小时的观察期内，12例AHF患者和9例严重脓毒症或脓毒性休克患者同时进行了4次PAC和PiCCO血流动力学测量。使用Mann-Whitney U检验进行组间比较。包括所有测量，使用线性回归分析建立数据对之间的相关性，并表示为Pearson相关系数的平方（r2）。与脓毒症患者相比，AHF患者的心脏指数、心功能指数（CFI）、射血分数、混合静脉血氧饱和度（SmvO2）和肺血管通透性指数显著降低，但肺动脉闭塞压升高。CFI小于4.5/min的所有患者的SmvO2均不大于70%。在两组中，CFI与左室每搏作功指数（脓毒症：r2 = 0.30，P <0.05; AHF：r2 = 0.23，P <0.05）和心功率（脓毒症：r2 = 0.39，P <0.05; AHF：r2 = 0.45，P <0.05）相关。在重症医学患者中，使用经皮热稀释技术评估心脏功能是PAC的替代方法。低CFI可识别AHF和脓毒症患者的心功能不全。
There is limited clinical experience with the single-indicator transpulmonary thermodilution (pulse contour cardiac output, or PiCCO) technique in critically ill medical patients, particularly in those with acute heart failure (AHF). Therefore, we compared the cardiac function of patients with AHF or sepsis using the pulmonary artery catheter (PAC) and the PiCCO technology. This retrospective observational study was conducted in the medical intensive care unit of a university hospital. Twelve patients with AHF and nine patients with severe sepsis or septic shock had four simultaneous hemodynamic measurements by PAC and PiCCO during a 24-hour observation period. Comparisons between groups were made with the use of the Mann-Whitney U test. Including all measurements, correlations between data pairs were established using linear regression analysis and are expressed as the square of Pearson's correlation coefficients (r2). Compared to septic patients, AHF patients had a significantly lower cardiac index, cardiac function index (CFI), global ejection fraction, mixed venous oxygen saturation (SmvO2) and pulmonary vascular permeability index, but higher pulmonary artery occlusion pressure. All patients with a CFI less than 4.5 per minute had an SmvO2 not greater than 70%. In both groups, the CFI correlated with the left ventricular stroke work index (sepsis: r2 = 0.30, P < 0.05; AHF: r2 = 0.23, P < 0.05) and cardiac power (sepsis: r2 = 0.39, P < 0.05; AHF: r2 = 0.45, P < 0.05). In critically ill medical patients, assessment of cardiac function using transpulmonary thermodilution technique is an alternative to the PAC. A low CFI identifies cardiac dysfunction in both AHF and septic patients.
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影响因子：
168.9
作者：
Harvey, S;Harrison, DA;Rowan, K
通讯作者：
Rowan, K
影响因子：
38.9
作者：
Antonelli, Massimo;Levy, Mitchell;Torres, Antoni
通讯作者：
Torres, Antoni
影响因子：
38.9
作者：
Goepfert, Matthias S. G.;Reuter, Daniel A.;Goetz, Alwin E.
通讯作者：
Goetz, Alwin E.
影响因子：
38.9
作者：
LICHTWARCKASCHOFF, M;ZERAVIK, J;PFEIFFER, UJ
通讯作者：
PFEIFFER, UJ
影响因子：
3.3
作者：
MEIER, P;ZIERLER, KL
通讯作者：
ZIERLER, KL