Ability of pulse power, esophageal Doppler, and arterial pulse pressure to estimate rapid changes in stroke volume in humans
Ability of pulse power, esophageal Doppler, and arterial pulse pressure to estimate rapid changes in stroke volume in humans
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DOI：
10.1097/ccm.0b013e31818b31f0
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发表时间：
2008-11-01
影响因子：
8.8
通讯作者：
Pinsky, Michael R.
中科院分区：
文献类型：
--
作者：
Marquez, Jose;McCurry, Kenneth;Pinsky, Michael R.
简介：由正压呼吸引起的动脉脉压变化和左心室每搏输出量变化的测量值与前负荷反应性成比例变化。然而，市售装置报告动态左心室每搏输出量变化的准确性从未得到验证。我们比较了两种美国食品和药物管理局批准的主动脉血流监测设备（一种使用动脉脉冲功率（LiDCOplus（TM）），另一种使用食管多普勒监测仪（HemoSonic（TM）））报告的动脉脉压测量值和左心室每搏输出量估计值的准确性。我们比较了7例麻醉开胸心脏手术患者在静脉阻断和释放操作过程中左心室每搏输出量的估计值及其变化，并将其与放置在主动脉根部周围的校准主动脉流量探头进行了逐搏比较。动脉脉压的动态变化与左心室每搏输出量的变化密切相关（平均r（2）.96）。两种器械均显示出与稳态呼吸暂停左心室每搏输出量值的良好一致性，与左心室每搏输出量动态变化的中度一致性（食管多普勒监测仪-1 +/- 22 mL，脉冲功率-7 +/- 12 mL，偏倚2 SO）。在一般情况下，脉冲功率信号往往低估左心室每搏输出量在较高的左心室每搏输出量value.Conclusion：动脉脉压，以及，从食管多普勒监测和脉冲功率估计左心室每搏输出量反映了短期稳态左心室每搏输出量值和道动态变化，左心室每搏输出量适度以及在人类。(Crit Care Med 2008; 36：3001-3007）
Introduction: Measures of arterial pulse pressure variation and left ventricular stroke volume variation induced by positive-pressure breathing vary in proportion to preload responsiveness. However, the accuracy of commercially available devices to report dynamic left ventricular stroke volume variation has never been validated.Methods. We compared the accuracy of measured arterial pulse pressure and estimated left ventricular stroke volume reported from two Food and Drug Administration-approved aortic flow monitoring devices, one using arterial pulse power (LiDCOplus(TM)) and the other esophageal Doppler monitor (HemoSonic(TM)). We compared estimated left ventricular stroke volume and their changes during a venous occlusion and release maneuver to a calibrated aortic flow probe placed around the aortic root on a beat-to-beat basis in seven anesthetized open-chested cardiac surgery patients.Results. Dynamic changes in arterial pulse pressure closely tracked left ventricular stroke volume changes (mean r(2) .96). Both devices showed good agreement with steady-state apneic left ventricular stroke volume values and moderate agreement with dynamic changes in left ventricular stroke volume (esophageal Doppler monitor -1 +/- 22 mL, and pulse power -7 +/- 12 mL, bias 2 SO). In general, the pulse power signals tended to underestimate left ventricular stroke volume at higher left ventricular stroke volume values.Conclusion: Arterial pulse pressure, as well as, left ventricular stroke volume estimated from esophageal Doppler monitor and pulse power reflects short-term steady-state left ventricular stroke volume values and tract dynamic changes in left ventricular stroke volume moderately well in humans. (Crit Care Med 2008; 36:3001-3007)