The utility of intra-operative three-dimensional transoesophageal echocardiography for dynamic measurement of stroke volume
The utility of intra-operative three-dimensional transoesophageal echocardiography for dynamic measurement of stroke volume
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术中三维经食管超声心动图动态测量每搏输出量的应用
DOI：
10.1111/anae.12857
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发表时间：
2015
期刊：
影响因子：
10.7
通讯作者：
Kiyonobu Nishikawa
中科院分区：
文献类型：
--
作者：
Koichi Suehiro;Katsuaki Tanaka ;Tokuhiro Yamada;Tadashi Matsuura ;Tomoharu Funao;Takashi Mori;Kiyonobu Nishikawa
测量左心室每搏输出量和心输出量对于管理血流动力学不稳定或危重患者非常重要。本研究的目的是比较通过三维经食管超声心动图测量的每搏输出量与使用肺动脉导管测量的每搏输出量，并检查三维经食管超声心动图跟踪血流动力学干预诱导的每搏输出量变化的能力。该研究包括40例心脏手术患者。分别于术前及术后2 min测定血流动力学参数，其中苯乙哌啶100 μg或麻黄碱5 mg。我们使用Bland-Altman分析来评估通过三维经食管超声心动图和肺动脉导管测量的每搏输出量之间的一致性。使用极图和四象限图分析评估三维经食管超声心动图与肺动脉导管相比的趋势能力。偏倚和百分比误差分别为-1.2 ml和20%。苯丙氨酸和麻黄碱给药后四象限分析的一致率分别为75%和84%。在极坐标图分析中，苯肾上腺素和麻黄碱给药后的角度一致率分别为66%和73%。三维经食管超声心动图测量每搏输出量在临床上是可接受的;但是，它在跟踪血液动力学干预后的每搏输出量变化方面不够可靠。
Measurement of left ventricular stroke volume and cardiac output is very important for managing haemodynamically unstable or critically ill patients. The aims of this study were to compare stroke volume measured by three‐dimensional transoesophageal echocardiography with stroke volume measured using a pulmonary artery catheter, and to examine the ability of three‐dimensional transoesophageal echocardiography to track stroke volume changes induced by haemodynamic interventions. This study included 40 cardiac surgery patients. Haemodynamic variables were measured before and 2 min after haemodynamic interventions, which consisted of phenylephrine 100 μg or ephedrine 5 mg. We used Bland–Altman analysis to assess the agreement between the stroke volume measured by three‐dimensional transoesophageal echocardiography and by the pulmonary artery catheter. Polar‐plot and 4‐quadrant plot analyses were used to assess the trending ability of three‐dimensional transoesophageal echocardiography compared with the pulmonary artery catheter. Bias and percentage error were −1.2 ml and 20%, respectively. The concordance rate in the 4‐quadrant analysis after phenylephrine and ephedrine administration was 75% and 84%, respectively. In the polar‐plot analysis, the angular concordance rate was 66% and 73% after phenylephrine and ephedrine administration, respectively. Three‐dimensional transoesophageal echocardiography was clinically acceptable for measuring stroke volume; however, it was not sufficiently reliable for tracking stroke volume changes after haemodynamic interventions.