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Vigileo-FloTrac系统两个版本(1.03和1.07)用于每搏输出量估计的比较:与食管多普勒测量的多中心、盲法比较

Comparison of two versions of the Vigileo-FloTrac system (1.03 and 1.07) for stroke volume estimation: a multicentre, blinded comparison with oesophageal Doppler measurements.

作者信息

Chatti R, de Rudniki S, Marqué S, Dumenil A S, Descorps-Declère A, Cariou A, Duranteau J, Aout M, Vicaut E, Cholley B P

机构信息

Département d'Anesthésie-Réanimation, AP-HP, Hôpital Lariboisière, Paris, France.

出版信息

Br J Anaesth. 2009 Apr;102(4):463-9. doi: 10.1093/bja/aep020. Epub 2009 Feb 25.

Abstract

BACKGROUND

Our aim was to evaluate the validity of stroke volume measurements obtained using the Vigileo-FloTrac system in comparison with those obtained using oesophageal Doppler considered as a reference.

METHODS

Prospective, multicentre study (four university hospitals), in which investigators were blinded to stroke volume values acquired simultaneously with the other technique. Two different versions of the Vigileo software (1.03 and 1.07) were studied and compared over two consecutive periods of time. Forty critically ill patients (three ICUs) and 20 high-risk surgical patients (one operating theatre) were studied over a 6-month period.

RESULTS

Two hundred and forty paired stroke volume values obtained using the second version of the Vigileo (1.07) yielded better correlation and agreement (R=0.48, P<0.001; bias=4 ml, limits of agreement: +/- 41 ml) than the 207 paired values obtained using version 1.03 (R=0.12, P=0.1; bias=1 ml, limits of agreement: +/- 75 ml). However, even with the second version, the percentage error in stroke volume measurement was 58%, a value still above the range considered clinically acceptable (30%).

CONCLUSIONS

The precision of stroke volume estimation using Vigileo-FloTrac has improved with the second version of the software (1.07), but remains insufficient to allow the replacement of the reference technique in the population studied.

摘要

背景

我们的目的是评估使用Vigileo - FloTrac系统获得的每搏量测量值与作为参考的食管多普勒获得的测量值相比的有效性。

方法

前瞻性多中心研究(四家大学医院),研究人员对与另一种技术同时获得的每搏量值不知情。在两个连续时间段内研究并比较了Vigileo软件的两个不同版本(1.03和1.07)。在6个月期间对40例危重症患者(三个重症监护病房)和20例高危手术患者(一个手术室)进行了研究。

结果

使用Vigileo第二个版本(1.07)获得的240对每搏量值比使用1.03版本获得的207对每搏量值具有更好的相关性和一致性(R = 0.48,P < 0.001;偏差 = 4 ml,一致性界限:±41 ml)(R = 0.12,P = 0.1;偏差 = 1 ml,一致性界限:±75 ml)。然而,即使使用第二个版本,每搏量测量的百分比误差仍为58%,该值仍高于临床可接受范围(30%)。

结论

使用Vigileo - FloTrac进行每搏量估计的精度在软件第二个版本(1.07)中有所提高,但仍不足以在研究人群中替代参考技术。

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