Hofer Christoph K, Ganter Michael T, Zollinger Andreas
Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital, Switzerland.
Curr Opin Crit Care. 2007 Jun;13(3):308-17. doi: 10.1097/MCC.0b013e3280c56afb.
Several less invasive cardiac output monitoring techniques are now commercially available and have the potential to replace the pulmonary artery catheter under certain clinical circumstances. The aim of this review is to give a synopsis of the currently available cardiac output measurement methods. This information should help in selecting the appropriate technique in a particular clinical setting.
An overview is given of the currently available techniques for cardiac output monitoring. Recent validation studies demonstrate that pulse wave analysis may be used reliably as an alternative to the pulmonary artery catheter in different clinical settings. The use of transesophageal echocardiography and Doppler measurements is limited due to high operator dependency, the partial carbon dioxide rebreathing technique should be applied in a precisely defined clinical setting to mechanically ventilated patients only, and pulsed dye densitometry as well as the bioimpedance technique are currently primarily applied in an investigational setting.
Less invasive cardiac output monitoring techniques may replace the pulmonary artery catheter in different clinical settings considering the specific properties of these techniques. The pulmonary artery catheter, however, may still be recommended for cardiac output measurement in specific clinical situations when monitoring of pulmonary artery pressures is desirable.
目前已有多种侵入性较小的心输出量监测技术可供商业使用，并且在某些临床情况下有取代肺动脉导管的潜力。本综述的目的是简要介绍当前可用的心输出量测量方法。这些信息应有助于在特定临床环境中选择合适的技术。
对当前可用的心输出量监测技术进行了概述。最近的验证研究表明，在不同临床环境中，脉搏波分析可可靠地用作肺动脉导管的替代方法。经食管超声心动图和多普勒测量的使用受到限制，原因是高度依赖操作人员；部分二氧化碳重呼吸技术应仅在精确界定的临床环境中应用于机械通气患者；脉冲染料密度测定法以及生物阻抗技术目前主要应用于研究环境。
考虑到这些技术的特定特性，侵入性较小的心输出量监测技术在不同临床环境中可能会取代肺动脉导管。然而，在需要监测肺动脉压力的特定临床情况下，仍可能推荐使用肺动脉导管来测量心输出量。
