Jover J L, Soro M, Belda F J, Aguilar G, Caro P, Ferrandis R
Servicio de Anestesiología y Reanimación, Hospital Virgen de los Lirios, Alcoy, Alicante.
Rev Esp Anestesiol Reanim. 2005 May;52(5):256-62.
Cardiac output is usually monitored with a pulmonary artery catheter. However, because that method is not free of risk, devices have been designed in recent years to measure cardiac output in a way that is minimally invasive or fully noninvasive. Among such devices is the NICO monitor, which is based on a modified Fick equation (partial CO2 rebreathing).
To compare the accuracy of cardiac output measurements from the NICO monitor to measurements obtained by continuous thermodilution with a pulmonary artery catheter.
A nonprobabilistic, consecutive sample of 20 patients was enrolled in the early postoperative period after elective cardiac surgery (coronary or valve procedures) in the recovery ward. Seven measurements of cardiac output were taken simultaneously with each method in each patient.
Cardiac output estimated by the partial CO2 rebreathing method was lower than the measurement obtained by the pulmonary artery catheter. The percentage error between the 2 methods was 37%, indicating that the NICO monitor can not substitute for the traditional method. The better correlation found between normal-to-low cardiac output values and the absence of side effects of using the NICO method suggest that it might be indicated for detecting low cardiac output after cardiac surgery, especially when the risk-benefit ratio does not favor using a pulmonary artery catheter.
心输出量通常用肺动脉导管进行监测。然而，由于该方法并非没有风险，近年来已设计出一些设备，以微创或完全无创的方式测量心输出量。其中一种设备是NICO监测仪，它基于修正的菲克方程（部分二氧化碳重吸入法）。
比较NICO监测仪测量的心输出量与通过肺动脉导管连续热稀释法获得的心输出量测量值的准确性。
选取20例择期心脏手术后（冠状动脉或瓣膜手术）在恢复病房的患者作为非概率连续样本。每位患者每种方法同时进行7次心输出量测量。
部分二氧化碳重吸入法估算的心输出量低于肺动脉导管测量值。两种方法之间的百分比误差为37%，表明NICO监测仪不能替代传统方法。在心输出量正常至较低值与使用NICO方法无副作用之间发现的更好相关性表明，它可能适用于检测心脏手术后的心输出量降低，特别是当风险效益比不支持使用肺动脉导管时。
