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[采用热-钠双指示剂稀释技术测量血管外肺水所涉及的准确性及临床问题]

[Accuracy and clinical problems involved in the measurements of extravascular lung water, using the thermal-sodium double indicator dilution technique].

作者信息

Watanabe A, Tanaka A, Kimura N, Watanabe N, Kusajima K, Abe T, Komatsu S

机构信息

Second Department of Surgery, Sapporo Medical College.

出版信息

Kokyu To Junkan. 1991 Jan;39(1):63-6.

PMID:2024075
Abstract

In this report, we evaluated and discussed the accuracy and the clinical problems involved in measurements of extravascular lung water volume (EVLW), using the thermal-sodium double indicator dilution technique. We measured EVLW in 2 groups, group I (normal cardiac function group) consisting of 20 patients with esophageal cancer, and group II (low cardiac function group) consisting of 27 patients with heart valvular disease. No significant difference was found between the two groups in the reproducibility (SDM/Average X 100) of measurements of Cardiac output (CO), MTT (Mean Transient Time), and EVLW. No correlation was found between circulatory parameters and the reproducibility of measurement of EVLW. So we assumed that cardiac function has no influence on the reproducibility of EVLW measurement. But the CO measured with EVLW catheter was significantly higher than that measured with Swan-Ganz catheter in group II. We thought that EVLW should be calculated using the CO measured with Swan-Ganz catheter in cases of low cardiac function. Infection, thromboembolism and bleeding after the insertion of the catheter, overload of water and sodium due to the injection of the indicator were thought to be complications of measurement of EVLW. But in our clinical cases there was no such complication.

摘要

在本报告中,我们使用热-钠双指示剂稀释技术评估并讨论了血管外肺水容量(EVLW)测量中涉及的准确性和临床问题。我们对两组患者进行了EVLW测量,第一组(心功能正常组)由20例食管癌患者组成,第二组(心功能低下组)由27例心脏瓣膜病患者组成。两组在心输出量(CO)、平均过渡时间(MTT)和EVLW测量的重复性(标准差/平均值×100)方面未发现显著差异。循环参数与EVLW测量的重复性之间未发现相关性。因此我们认为心功能对EVLW测量的重复性没有影响。但在第二组中,使用EVLW导管测得的CO显著高于使用Swan-Ganz导管测得的CO。我们认为在心功能低下的情况下,应使用Swan-Ganz导管测得的CO来计算EVLW。导管插入后的感染、血栓栓塞和出血,以及指示剂注射导致的水钠超载被认为是EVLW测量的并发症。但在我们的临床病例中没有此类并发症。

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