Department of Anesthesiology, Hamburg-Eppendorf University Hospital, Martinistr. 52, 20246 Hamburg, Germany.
Anesth Analg. 2010 Mar 1;110(3):799-811. doi: 10.1213/ANE.0b013e3181cc885a.
The ability to monitor cardiac output is one of the important cornerstones of hemodynamic assessment for managing critically ill patients at increased risk for developing cardiac complications, and in particular in patients with preexisting cardiovascular comorbidities. For >30 years, single-bolus thermodilution measurement through a pulmonary artery catheter for assessment of cardiac output has been widely accepted as the "clinical standard" for advanced hemodynamic monitoring. In this article, we review this clinical standard, along with current alternatives also based on the indicator-dilution technique, such as the transcardiopulmonary thermodilution and lithium dilution techniques. In this review, not only the underlying technical principles and the unique features but also the limitations of each application of indicator dilution are outlined.
监测心输出量的能力是评估危重病患者血流动力学的重要基石之一，这些患者发生心脏并发症的风险增加，特别是那些存在心血管合并症的患者。30 多年来，通过肺动脉导管进行单次热稀释测量评估心输出量已被广泛接受为先进血流动力学监测的“临床标准”。在本文中，我们回顾了这一临床标准，以及当前基于指示剂稀释技术的替代方法，如跨心肺热稀释技术和锂稀释技术。在这篇综述中，不仅概述了指示剂稀释的基本技术原理和独特特征，还概述了每种应用的局限性。
