Systemic vascular resistance has an impact on the reliability of the Vigileo-FloTrac system in measuring cardiac output and tracking cardiac output changes
Systemic vascular resistance has an impact on the reliability of the Vigileo-FloTrac system in measuring cardiac output and tracking cardiac output changes
复制标题
全身血管阻力会影响 Vigileo-FloTrac 系统测量心输出量和跟踪心输出量变化的可靠性
DOI：
10.1093/bja/aet022
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发表时间：
2013
影响因子：
9.8
通讯作者：
Koichi Suehiro
中科院分区：
文献类型：
--
作者：
祖父江和哉;高柳猛彦;平手博之;杉浦健之;藤田義人;浅井清文;Koichi Suehiro
BackgroundThe本研究的目的是检查Vigileo-FloTrac系统测量心输出量（CO）和跟踪血管紧张度增加引起的CO变化的能力，在不同状态的全身血管阻力（SVR）下。在苯肾上腺素（100 μg）给药前（T1）和给药后2 min（T2）记录血流动力学参数，包括Vigileo-FloTrac系统（3.02版）（APCO）测量的CO、肺动脉导管（ICO）测量的CO和SVR指数（SVRI）。使用Bland和Altman分析比较T1时的ICO和APCO。我们使用四象限图和极坐标图来比较ICO和APCO之间的趋势能力。根据T1时的SVRI值将患者分为三组：低SVRI状态（<1200 dyn cm− 5 m2）、正常SVRI状态（1200-2500 dyn cm− 5 m2）和高SVRI状态（>2500 dyn cm− 5 m2）。校正的百分比误差分别为46.3%、26.4%和61.4%，在低、正常和高SVRI状态下，ΔICO和ΔAPCO之间的一致率分别为67.5%、28.8%和7.7%。极坐标图分析表明，平均角偏差为−22.3°，−46.0°和−3.51°，径向一致性的限制分别为70°，85°和87°，在低，正常，高SVRI状态，conclusionsThese结果表明，Vigileo-FloTrac系统测量CO和跟踪苯肾上腺素管理引起的CO变化的可靠性是不可接受的临床。
BackgroundThe aim of this study was to examine the ability of the Vigileo-FloTrac system to measure cardiac output (CO) and track changes in CO induced by increased vasomotor tone, under different states of systemic vascular resistance (SVR).MethodsForty patients undergoing cardiac surgery were enrolled. Haemodynamic variables including CO measured by the Vigileo-FloTrac system (version 3.02) (APCO), CO measured by a pulmonary artery catheter (ICO), and SVR index (SVRI) were recorded before (T1) and 2 min after (T2) phenylephrine administration (100 μg). Bland and Altman analysis was used to compare ICO and APCO at T1. We used four-quadrant plots and polar plots to compare the trending abilities between ICO and APCO. Patients were divided into three groups according to the SVRI value at T1, with low (<1200 dyn cm−5m2), normal (1200–2500 dyn cm−5m2), and high (>2500 dyn cm−5m2) SVRI states.ResultsA total of 155 paired data were collected. The adjusted percentage error was 46.3%, 26.4%, and 61.4%, and the concordance rate between ΔICO and ΔAPCO was 67.5%, 28.8%, and 7.7% in the low, normal, and high SVRI state, respectively. The polar plot analysis showed that the mean angular bias was −22.3°, −46.0°, and −3.51°, and the radial limits of agreement were 70°, 85°, and 87°, in the low, normal, and high SVRI state, respectively.ConclusionsThese results indicate that the reliability of the Vigileo-FloTrac system to measure CO and track changes in CO induced by phenylephrine administration was not clinically acceptable.