Mielck Frank, Buhre Wolfgang, Hanekop Gunnar, Tirilomis Theodor, Hilgers Reinhard, Sonntag Hans
Departments of Anesthesiology, and Medical Statistics, University of Goettingen, Germany.
J Cardiothorac Vasc Anesth. 2003 Apr;17(2):211-6. doi: 10.1053/jcan.2003.49.
To investigate in a direct comparison accuracy and precision of continuous cardiac output measurements assessed by continuous pulmonary artery thermodilution technique (TDCCO), continuous pulse contour analysis (PCCO), and noninvasive partial CO(2)-rebreathing technique (NICO) in patients after coronary artery bypass grafting (CABG) during the postoperative period.
Prospective, controlled clinical study.
University hospital.
Twenty-two patients undergoing elective CABG surgery.
Hemodynamic measurements were performed after admission to the ICU and in sequence every 2 hours during the subsequent 6-hour period. Simultaneously, cardiac output (CO) was measured using a TDCCO, PCCO, and NICO. After the continuous cardiac output measurements were read, bolus thermodilution-derived cardiac output was obtained from thermodilution curves detected in the pulmonary artery (TDBCO(pa)). Four intermittent consecutive boli consisting of 10 mL of ice-cold saline were randomly injected over the ventilatory cycle.
The comparison between the continuous cardiac output measurement methods TDCCO versus PCCO showed a bias of -0.12 L/min, between TDCCO versus NICO -0.17 L/min, and between PCCO versus NICO -0.44 L/min. The comparison to the reference technique between TDBCO(pa) versus TDCCO revealed a bias of -0.28 L/min, between TDBCO(pa) versus PCCO -0.40 L/min, and between TDBCO(pa) versus NICO -0.64 L/min.
The results of this clinical investigation show agreement between TDCCO and PCCO to satisfy clinical requirements in a setting of postoperative patients after cardiac surgery. In contrast, the NICO monitor is of very limited use in these patients.
在冠状动脉旁路移植术（CABG）术后患者的术后期间，通过直接比较，研究连续肺动脉热稀释技术（TDCCO）、连续脉搏轮廓分析（PCCO）和无创部分二氧化碳重呼吸技术（NICO）评估连续心输出量测量的准确性和精密度。
前瞻性对照临床研究。
大学医院。
22例行择期CABG手术的患者。
患者入住重症监护病房（ICU）后进行血流动力学测量，并在随后的6小时内每2小时依次进行一次。同时，使用TDCCO、PCCO和NICO测量心输出量（CO）。在读取连续心输出量测量值后，从肺动脉检测到的热稀释曲线中获得推注热稀释衍生的心输出量（TDBCO(pa)）。在通气周期内随机注射4次连续的10 mL冷盐水推注。
连续心输出量测量方法TDCCO与PCCO之间的比较显示偏差为-0.12 L/min，TDCCO与NICO之间为-0.17 L/min，PCCO与NICO之间为-0.44 L/min。TDBCO(pa)与TDCCO之间与参考技术的比较显示偏差为-0.28 L/min, TDBCO(pa)与PCCO之间为-0.40 L/min，TDBCO(pa)与NICO之间为-0.64 L/min。
这项临床研究结果表明，TDCCO和PCCO之间的一致性能够满足心脏手术后术后患者的临床需求。相比之下，NICO监测仪在这些患者中的用途非常有限。
