重症监护患者动脉监测导管短期和长期血流动力学及功能影响的前瞻性对照研究

Prospective comparative study on the hemodynamic and functional consequences of arterial monitoring catheters in intensive care patients on the short and long term.

作者信息

Hoencamp Riro, Ulrich Chris, Verschuren Sabine A J, van Baalen Jari M

机构信息

University Medical Center, Leiden, The Netherlands.

出版信息

J Crit Care. 2006 Jun;21(2):193-6. doi: 10.1016/j.jcrc.2005.12.011.

DOI:10.1016/j.jcrc.2005.12.011

PMID:16769467

Abstract

INTRODUCTION

In intensive care wards, arterial catheters are a relevant instrument to monitor vital functions. However, the effect of arterial catheterization on hemodynamic function in elective patients in the short and long term is unknown.

AIM

The objective of this study was to examine the possible damaging effects of arterial monitoring catheters on arterial functioning in intensive care patients after elective surgery.

PATIENTS AND METHODS

Twenty-three patients with an arterial catheter were examined; the nonaffected arm was used as control. The use of the a. radialis/a. ulnaris ratio for the assessment of artery functioning was validated with 20 healthy individuals and the nonaffected control arm of the examined patients. Arterial function was measured with a Doppler monitoring device and a subjective assessment distress list. All patients were assessed before insertion and 1 day, 5 days, and 30 days after removal. Data were analyzed by means of multivariate analysis of variance and t test.

RESULTS

A significant decrease in the a. radialis/a. ulnaris ratio was found 1 day and 5 days after removal (t1 P = .04, t5 P = .003, and multivariate analysis of variance P = .033), against no significant change after 30 days. Subjective assessment showed no relevant clinical negative impact.

CONCLUSION

There is significant change in the hemodynamic function of the artery 1 day and 5 days after removal, but this significant change disappears after 30 days. An arterial monitoring catheter causes a functional arterial change in the affected arm in the short term and no significant difference in the long term. Therefore, arterial catheterization is a safe procedure after short-term cannulation. Second, the systolic blood pressure ratio of the a. radialis/a. ulnaris is a valuable tool in the assessment of the hemodynamic function of the a. radialis after radial cannulation.

摘要

引言

在重症监护病房，动脉导管是监测生命功能的重要工具。然而，动脉插管对择期手术患者短期和长期血流动力学功能的影响尚不清楚。

目的

本研究的目的是探讨动脉监测导管对择期手术后重症监护患者动脉功能的潜在损害作用。

患者与方法

对23例留置动脉导管的患者进行检查；将未受影响的手臂作为对照。使用20名健康个体以及所检查患者未受影响的对照手臂，验证使用桡动脉/尺动脉比值评估动脉功能的方法。使用多普勒监测设备和主观评估痛苦清单测量动脉功能。在插入导管前以及拔除导管后1天、5天和30天对所有患者进行评估。通过多变量方差分析和t检验对数据进行分析。