A New Echocardiographic Tool for Cardiac Output Evaluation: An Experimental Study
A New Echocardiographic Tool for Cardiac Output Evaluation: An Experimental Study
复制标题
DOI：
10.1097/shk.0000000000001273
复制
发表时间：
2019-10-01
期刊：
影响因子：
3.1
通讯作者：
Markarian, Thibaut
中科院分区：
文献类型：
--
作者：
Bobbia, Xavier;Muller, Laurent;Markarian, Thibaut
背景资料：根据不同的研究，超声心动图评估的心输出量（CO）与热稀释法（COth）测量的CO之间的相关性各不相同。新的经胸超声心动图（TTE）工具可自动计算主动脉下速度时间指数（VTIauto）和CO（COauto）。主要目的是评估麻醉、通气的仔猪失血性休克（HS）模型中COth和COauto之间的相关性。次要目的是评价COth与通过手动测量VTI评价的CO之间的相关性，以及VTIvaresp的前负荷依赖性。方法：18只小猪流血的，直到平均动脉压达到40 mm Hg。在复苏阶段之前，控制出血持续30分钟。采用Pulse index Contour心输出量热稀释法测定CO。在实验的每个时间，测量三个VTI值（min、med、max）并计算平均值。通过TTE计算CO（COmax、COmed、COmin、COave）。结果：204次测量中，人工测量成功197次（97%），自动测量成功122次（60%）（P < 0.01）。COth分别与COauto、COave、COmax、COmed和COmin之间的相关系数（r）为：0.83（95% CI [0.76; 0.88]; P < 0.01），0.54（95% CI [0.43; 0.63]; P < 0.01）、0.43（95% CI [0.31; 0.54]; P < 0.01）、0.58（95% CI [0.48; 0.67]; P < 0.01）和0.52（95% CI [0.41; 0.62]; P < 0.01）。结论：在HS的实验模型中，一种新的超声工具COauto似乎比手动超声心动图测量与COth的相关性更好。
Background: The correlation between cardiac output (CO) evaluated by echocardiography and CO measured by thermodilution (COth) varies according to different studies. A new transthoracic echocardiography (TTE) tool allows automatic calculation of the subaortic velocity time index (VTIauto) and CO (COauto). The main objective was to evaluate the correlation between COth and COauto in an anesthetized, ventilated piglet hemorrhagic shock (HS) model. The secondary objectives were to evaluate the correlation between COth and CO evaluated by manual measurements of VTI, and the preload-dependency of VTIvaresp. Methods: Eighteen piglets were bled until mean arterial pressure reached 40 mm Hg. Controlled hemorrhage was maintained for 30 min before a resuscitation phase. CO was measured by Pulse index Contour Cardiac Output thermodilution methods. At each time of the experiment, three VTI values were measured (min, med, max) and the average value was calculated. COs were calculated by TTE (COmax, COmed, COmin, COave). Results: For the 204 measures attempted, the success rate was 197 (97%) manually and 122 (60%) automatically (P < 0.01). The correlation coefficients (r) between COth and, respectively, COauto, COave, COmax, COmed, and COmin were: 0.83 (95% CI [0.76; 0.88]; P < 0.01), 0.54 (95% CI [0.43; 0.63]; P < 0.01), 0.43 (95% CI [0.31; 0.54]; P < 0.01), 0.58 (95% CI [0.48; 0.67]; P < 0.01), and 0.52 (95% CI [0.41; 0.62]; P < 0.01). Conclusion: In an experimental model of HS, a new ultrasound tool, COauto, seems better correlated with COth than manual echocardiographic measurements.