Continuous stroke volume monitoring by modelling flow from non-invasive measurement of arterial pressure in humans under orthostatic stress
Continuous stroke volume monitoring by modelling flow from non-invasive measurement of arterial pressure in humans under orthostatic stress
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DOI：
10.1042/cs19990061
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发表时间：
1999-09-01
期刊：
影响因子：
6
通讯作者：
van Lieshout, JJ
中科院分区：
文献类型：
--
作者：
Harms, MPM;Wesseling, KH;van Lieshout, JJ
主动脉流量和压力之间的关系由动脉输入阻抗的三元模型描述，包括对主动脉直径和顺应性变化的连续校正（Modelflow）。 Mle 通过该模型根据动脉压计算出主动脉流量，并评估在直立性压力下，流量是否可以通过有创和无创的动脉压测定得出。在 10 名年轻人中，Modelflow 每搏输出量 (MFSV) 通过浴臂内动脉压 (IAP) 和无创手指压力 (FINAP) 测量值计算得出。为了进行比较，对以下位置的计算机控制的四个热稀释估计值（热稀释确定的每搏输出量；TDSV）进行了平均：仰卧、站立、低头倾斜 20 度 (HDT20) 以及抬头倾斜 30 度和 70 度（分别为 HUT30 和 HUT70）。由于热稀释注射故障，一名受试者的数据被丢弃。共有 160 个系列的 155 个录音可供比较。仰卧位 TDSV 为 113 +/- 13 ml（平均值 +/- S.D.），站立期间下降 40% 至 68 +/- 14 ml，HUT30 期间下降 24% 至 86 +/- 12 ml，HUT70 期间下降 51% 至 55 +/- 15 ml。在 HDT20 期间，TDSV 为 114 +/- 13 英里。 IAP 的 MFSV 在 HDT20 期间低估了 TDSV（-6 +/- 6 ml；P < 0.05），但 FINAP 的 MFSV 却没有（-4 +/- 7 ml；不显着）。对于 HUT70 和站立，IAP 的 MFSV 高估了 TDSV 11 +/- 10 ml（HUT70；P < 0.01）和 12 +/- 9 ml（站立；P < 0.01）。然而，FINAP 的 MFSV 偏移对于 HUT70 (3 +/- 8 ml) 或站立 (3 +/- 9 ml) 都不显着。总之，由于直立性，主动脉跨壁压的变化可能导致 MFSV 与 IAP 的抵消。然而，Modelflow 根据直立期间无创确定的手指压力正确计算了主动脉流量。
The relationship between aortic flow and pressure is described by a three-element model of the arterial input impedance, including continuous correction for variations in the diameter and the compliance of the aorta (Modelflow). Mle computed the aortic flow from arterial pressure by this model, and evaluated whether, under orthostatic stress, flow may be derived from both an invasive and a non-invasive determination of arterial pressure. In 10 young adults, Modelflow stroke volume (MFSV) was computed from bath intra-brachial arterial pressure (IAP) and noninvasive finger pressure (FINAP) measurements. For comparison, a computer-controlled series of four thermodilution estimates (thermodilution-determined stroke volume; TDSV) were averaged for the following positions: supine, standing, head-down tilt at 20 degrees (HDT20) and head-up tilt at 30 degrees and 70 degrees (HUT30 and HUT70 respectively). Data from one subject were discarded due to malfunctioning thermodilution injections. A total of 155 recordings from 160 series were available for comparison. The supine TDSV of 113 +/- 13 ml (mean +/- S.D.) dropped by 40% to 68 +/- 14 ml during standing, by 24% to 86 +/- 12 ml during HUT30, and by 51% to 55 +/- 15 ml during HUT70. During HDT20, TDSV was 114 +/- 13 mi. MFSV for IAP underestimated TDSV during HDT20 (-6 +/- 6 ml; P < 0.05), but that for FINAP did not (-4 +/- 7 ml; not significant). For HUT70 and standing, MFSV for IAP overestimated TDSV by 11 +/- 10 ml (HUT70; P < 0.01) and 12 +/- 9 ml (standing; P < 0.01). However, the offset of MFSV for FINAP was not significant for either HUT70 (3 +/- 8 ml) or standing (3 +/- 9 ml). In conclusion, due to orthostasis, changes in the aortic transmural pressure may lead to an offset in MFSV from IAP. However, Modelflow correctly calculated aortic flow from non-invasively determined finger pressure during orthostasis.