Kobayashi Makoto, Ko Masayoshi, Kimura Toshimoto, Meguro Eiji, Hayakawa Yoshiro, Irinoda Takashi, Takagane Akinori
Surgical Division, Hakodate Goryoukaku Hospital, 38-3 Goryoukaku-cho, Hakodate City, Hokkaido, Japan.
Expert Rev Med Devices. 2008 May;5(3):311-6. doi: 10.1586/17434440.5.3.311.
To assess the utility of a new arterial pressure-based cardiac output (FloTrac) and central venous oximetry (PreSep) monitoring system in the perioperative management of patients undergoing radical esophagectomy.
From May 2006, a new analyzing device (Vigileo monitor; Edwards Lifesciences LLC, Tokyo, Japan), which can be used in combination with the FloTrac and PreSep sensors, has been used in nine patients who have undergone radical operations for thoracic esophageal cancer at our hospital. Stroke volume variation (SVV), calculated for each respiratory cycle and displayed on the Vigileo monitor, precisely predicted intravascular hypovolemia. The maximum SVV of patients who needed fluid resuscitation was significantly higher than that of patients who had a stable circulation. The mean value of the maximum SVV in the patient with or without fluid resuscitation was 25 +/- 6.9 and 13 +/- 1.4%, respectively (p < 0.04). In addition, continuous monitoring of central venous oxygen saturation enabled evaluation of oxygen supply to tissues to aid in determining the need for red blood cell transfusion. The Vigileo monitor (with Flo Trac and PreSep sensors) provided reliable information for the perioperative management of high-risk patients after highly invasive general surgery without the need for an invasive central or pulmonary catheter.
评估一种基于动脉压的心输出量（FloTrac）和中心静脉血氧饱和度（PreSep）监测系统在食管癌根治术患者围手术期管理中的应用价值。
自2006年5月起，我院对9例接受胸段食管癌根治术的患者使用了一种可与FloTrac和PreSep传感器联合使用的新型分析设备（Vigileo监护仪；日本东京爱德华生命科学有限责任公司）。每个呼吸周期计算得出并显示在Vigileo监护仪上的每搏量变异度（SVV）能准确预测血管内容量不足。需要液体复苏的患者的最大SVV显著高于循环稳定的患者。有或没有进行液体复苏的患者的最大SVV平均值分别为25±6.9%和13±1.4%（p<0.04）。此外，持续监测中心静脉血氧饱和度能够评估组织的氧供情况，有助于确定是否需要输注红细胞。Vigileo监护仪（配备FloTrac和PreSep传感器）为高风险患者在接受高侵袭性普通外科手术后的围手术期管理提供了可靠信息，且无需置入有创中心静脉导管或肺动脉导管。
