Jaeggi Philip, Hofer Christoph K, Klaghofer Richard, Fodor Patricia, Genoni Michele, Zollinger Andreas
Institute of Anesthesiology, Triemli City Hospital, Zurich, Switzerland.
J Cardiothorac Vasc Anesth. 2003 Apr;17(2):217-20. doi: 10.1053/jcan.2003.50.
Assessment of hemodynamics by transesophageal Doppler devices (TDD) may be a less invasive alternative to the pulmonary artery catheter. In contrast to the TDD evaluated so far, a new monitor (HemoSonic100) measures both blood flow velocity and the diameter of the descending aorta. The aim of this study was to assess the accuracy of the cardiac output/index (CO/CI) measured by this device compared with the CO/CI measured by thermodilution.
Prospective nonrandomized study.
Community hospital; university-based statistician.
Twenty-two patients.
Elective coronary artery bypass grafting and/or valve replacement/repair.
After routine cardiac surgery, CO/CI was determined in the intensive care unit by iced-water bolus (IWB), continuous cardiac index (CCI) assessment, and the TDD. Matched measurements were made with each patient at intervals of 30 minutes. Six percent of sets were incomplete because of failed signal detection by the TDD. Bland-Altman analysis revealed a mean bias of 0.23 L/min/m(2) for TDD and IWB. Mean bias for CCI and IWB was 0.11 L/min/m(2). The correlation between TDD and IWB (r(2) = 0.09) for cardiac index was found to be inferior to the correlation between CCI and IWB (r(2) = 0.65). Trend analysis between sequential measurements (T1-4: dTDD, dCCI, dIWB) showed a lower correlation between dTDD and dIWB (r(2) = 0.1) compared with the correlation between dCCI and dIWB (r(2) = 0.44).
The transesophageal Doppler device (HemoSonic100) cannot be recommended as a sole method for monitoring cardiac output in patients after cardiac surgery.
经食管多普勒装置（TDD）评估血流动力学可能是一种比肺动脉导管侵入性更小的替代方法。与目前已评估的TDD不同，一种新型监测仪（HemoSonic100）可测量血流速度和降主动脉直径。本研究的目的是评估该装置测量的心输出量/指数（CO/CI）与热稀释法测量的CO/CI相比的准确性。
前瞻性非随机研究。
社区医院；大学统计学家。
22名患者。
择期冠状动脉搭桥术和/或瓣膜置换/修复术。
常规心脏手术后，在重症监护病房通过冷盐水推注（IWB）、连续心指数（CCI）评估和TDD测定CO/CI。每隔30分钟对每位患者进行配对测量。由于TDD信号检测失败，6%的测量组数据不完整。Bland-Altman分析显示，TDD与IWB测量的平均偏差为0.23 L/min/m²。CCI与IWB测量的平均偏差为0.11 L/min/m²。发现心脏指数方面TDD与IWB的相关性（r² = 0.09）低于CCI与IWB的相关性（r² = 0.65）。连续测量（T1 - 4：dTDD、dCCI、dIWB）的趋势分析显示，与dCCI和dIWB的相关性（r² = 0.44）相比，dTDD与dIWB的相关性较低（r² = 0.1）。
经食管多普勒装置（HemoSonic100）不能作为心脏手术后患者心输出量监测的唯一方法。
