Tsujimoto Yoshitaka, Tsutsui Masato, Kazama Tomiei, Ogura Takahiro, Fukuda Isao
Department of Anesthesiology, National Defense Medical College, Tokorozawa.
Masui. 2005 Oct;54(10):1138-42.
PulseCO is a low invasive apparatus to measure cardiac output continuously from arterial pulse waveform (PulseCCO). It is thought that the accuracy of PulseCCO measurement is clinically acceptable with stable hemodynamics. We measured and evaluated PulseCCO during inferior vena cava clamp (IVC clamp).
Anesthesia was induced with propofol and vecuronium. After induction, an arterial catheter and a pulmonary artery catheter were inserted, and anesthesia was maintained with general anesthesia and continuous epidural anesthesia. At first IVC was clamped for five minutes and after an interval of five minutes IVC was clamped again. During IVC clamp maneuver, we measured PulseCCO and continuous cardiac output with Vigilance (VigilanceCCO).
At the time of the first IVC clamp and declamp, VigilanceCCO was unchanged, but Pulse CCO showed a marked change. After the second IVC clamp, both PulseCCO and VigilanceCCO decreased, but the change was slower with VigilanceCCO.
With IVC clamp maneuver which is thought to cause rapid change of cardiac output, PulseCCO showed more rapid change in comparison with VigilanceCCO. In the state where hemodynamics change rapidly, PulseCO can be a more useful monitor.
脉搏心输出量监测仪(PulseCO)是一种通过动脉脉搏波形连续测量心输出量的低侵入性设备(脉搏心输出量监测,PulseCCO)。人们认为在血流动力学稳定的情况下,PulseCCO测量的准确性在临床上是可以接受的。我们在腔静脉钳夹(IVC钳夹)期间测量并评估了PulseCCO。
采用丙泊酚和维库溴铵诱导麻醉。诱导后,插入动脉导管和肺动脉导管,并用全身麻醉和连续硬膜外麻醉维持麻醉。首先将IVC钳夹5分钟,间隔5分钟后再次钳夹IVC。在IVC钳夹操作期间,我们用Vigilance(VigilanceCCO)测量了PulseCCO和连续心输出量。
在首次IVC钳夹和松开时,VigilanceCCO没有变化,但Pulse CCO有明显变化。第二次IVC钳夹后,PulseCCO和VigilanceCCO均下降,但VigilanceCCO的变化较慢。
在被认为会导致心输出量快速变化的IVC钳夹操作中,与VigilanceCCO相比,PulseCCO显示出更快的变化。在血流动力学快速变化的状态下,PulseCO可能是一种更有用的监测仪。