Wilsterman Sonya, Hackett Eileen S, Rao Sangeeta, Hackett Timothy B
Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
J Vet Emerg Crit Care (San Antonio). 2009 Jun;19(3):241-6. doi: 10.1111/j.1476-4431.2009.00420.x.
To investigate a technique of central venous pressure (CVP) measurement using a newly developed catheter in healthy adult horses.
Prospective experimental study.
University research facility.
Twenty healthy adult horses.
An equine central venous catheter was inserted into the jugular vein to a length of approximately 80 cm from the mid-cervical region in an attempt to catheterize the pulmonary artery. Pulmonary arterial catheterization was confirmed by echocardiography. Insertion distance and pressure were measured at this location with a disposable manometer. The catheter was then withdrawn until presence in the right atrium was confirmed by echocardiography. Insertion distance and pressure were also measured at this location. The catheter was then withdrawn in 5 cm increments until exiting the jugular insertion site with pressure measured at each location. All pressure measurements were taken with the manometer zero position at the point of the shoulder.
Pulmonary artery catheterization was successful in 16 of 20 horses. Mean pulmonary arterial pressure was 23.8 cm H2O (17.5 mm Hg) (95% confidence interval [CI] 20.9-26.7 cm H2O [15.4-19.6 mm Hg]). Mean right atrial pressure was 8.3 cm H2O (6.1 mm Hg) (95% CI 7.1-9.4 cm H2O [5.2-6.9 mm Hg]). Right atrial pressure was compared with pressures recorded at sequential insertion distances and resulted in a recommendation for catheter insertion of at least 40 cm for CVP measurement in adult horses. Jugular venous pressure measurement was statistically different from CVP measurement.
This catheter measurement technique is well tolerated in normal horses. Routine clinical use of this equine central venous catheter may improve our ability to monitor patients and improve patient care and outcomes of ill horses in hospital.
使用一种新开发的导管,研究健康成年马中心静脉压(CVP)的测量技术。
前瞻性实验研究。
大学研究机构。
20匹健康成年马。
将一根马用中心静脉导管插入颈静脉,从颈中部区域插入约80厘米,试图将其插入肺动脉。通过超声心动图确认肺动脉插管情况。在此位置用一次性压力计测量插入深度和压力。然后将导管拔出,直到通过超声心动图确认导管位于右心房。在此位置也测量插入深度和压力。然后以5厘米的增量拔出导管,直到导管从颈静脉插入部位退出,在每个位置测量压力。所有压力测量均在压力计零位位于肩部位置时进行。
20匹马中有16匹成功插入肺动脉。平均肺动脉压为23.8厘米水柱(17.5毫米汞柱)(95%置信区间[CI]为20.9 - 26.7厘米水柱[15.4 - 19.6毫米汞柱])。平均右心房压为8.3厘米水柱(6.1毫米汞柱)(95%CI为7.1 - 9.4厘米水柱[5.2 - 6.9毫米汞柱])。将右心房压与在连续插入深度记录的压力进行比较,得出在成年马中测量CVP时导管插入至少40厘米的建议。颈静脉压力测量与CVP测量在统计学上有差异。
这种导管测量技术在正常马匹中耐受性良好。这种马用中心静脉导管的常规临床应用可能会提高我们监测患病马匹的能力,并改善患病马匹在医院的护理及预后。