Reuter D A, Goetz A E
Klinik und Poliklinik für Anästhesiologie, Universitätskrankenhaus Hamburg Eppendorf, Hamburg.
Anaesthesist. 2005 Nov;54(11):1135-51; quiz 1152-3. doi: 10.1007/s00101-005-0924-0.
Diagnosis and therapy of hemodynamic instability are of the utmost importance in the treatment of critically ill patients during surgery and in intensive care. For both diagnosis and therapy, adequate and preferably continuous hemodynamic monitoring is essential. Besides the assessment of cardiac preload and blood pressure, cardiac output represents an important clinical marker of cardiac performance and global perfusion. Since its clinical introduction by Swan and Ganz in 1970, the standard technique for measuring cardiac output has been the pulmonary arterial thermodilution technique using a pulmonary artery catheter. The ongoing discussion on the risk-benefit ratio of such a pulmonary artery catheter has led to the introduction of several less invasive methods for determining cardiac output. The aim of this review is to provide background information on these alternative methods and to discuss the individual advantages and disadvantages of each method in the context of their clinical applicability.
血流动力学不稳定的诊断与治疗在外科手术及重症监护中危重症患者的治疗过程中至关重要。对于诊断和治疗而言，充分且最好是持续的血流动力学监测必不可少。除了评估心脏前负荷和血压外，心输出量是心脏功能和整体灌注的重要临床指标。自1970年Swan和Ganz将其临床应用以来，测量心输出量的标准技术一直是使用肺动脉导管的肺动脉热稀释技术。关于这种肺动脉导管风险效益比的持续讨论促使了几种侵入性较小的心输出量测定方法的出现。本综述的目的是提供这些替代方法的背景信息，并在其临床适用性的背景下讨论每种方法的个体优缺点。
