Grosse F Oliver, Holzhey David, Falk Volkmar, Schaarschmidt Jan, Kraemer Klaus, Mohr Friedrich W
Department of Cardiac Surgery, University of Leipzig, Heart Center, Leipzig, Germany.
J Extra Corpor Technol. 2010 Mar;42(1):61-70.
Reliable information about different blood parameters is essential in maintaining hemodynamics, perfusion, and gas exchange during cardiopulmonary bypass (CPB). For this purpose, a precise and continuous monitoring is needed. The objective of this in vitro study was to compare a novel continuous in-line blood parameter monitoring system versus a reference laboratory analyzer. The study was conducted as an in vitro prospective experimental study during a CPB simulation. The reliability of BMU 40 was tested in monitoring the pO2, oxygen saturation (SO2), and hematocrit (Hct) under physiological and extreme conditions with regards to temperature, oxygenation, and blood concentration. Four different tests were performed and conducted with five sensors each. Correlation analyses and Bland-Altman analyses were performed. A total of 350 measurement points were compared. All monitored values of blood parameters correlated highly with laboratory values (all r values >.90). Test 1: Biases of pO2 (act) varied from -3.24 mmHg (+/- 6.86 mmHg) up to 6.0 mmHg (+/- 17.89 mmHg). The biases of pO2 (37 degrees C) ranged from -3.52 mmHg (+/- 6.01 mmHg) up to 68.8 mmHg (+/- 67.82 mmHg). Test 2: The biases standard deviations (SD) for Hct ranged from -0.35% (+/- .79%) up to 2.35% (+/- .91%). The biases (SD) for SO2 varied from -.45% (+/- .86%) up to .85% (+/- 1.01%). Test 3: The biases (SD) of Hct ranged from -1.00% (+/- 1.84%) up to -.67% (+/- 1.49%). Test 4: The biases (SD) for SO2 varied from -.36% (+/- 1.60%) up to .48% (+/- .90%).The BMU 40 is a reliable device in measuring the partial oxygen pressure (pO2), SO2, and Hct under normal physiological and extreme conditions with regards to temperature, oxygenation, and blood concentration in simulation of CPB. The algorithm to calculate pO2 (37 degrees C) under hypothermic conditions needs to be adjusted. (Before the official market launch a new software version of the BMU 40 has been developed. The algorithm to calculate pO2 (37 degrees C) under hypothermic conditions has been improved and the miscalculation eliminated.)
在体外循环(CPB)期间,获取有关不同血液参数的可靠信息对于维持血流动力学、灌注和气体交换至关重要。为此,需要进行精确且持续的监测。本体外研究的目的是比较一种新型的连续在线血液参数监测系统与参考实验室分析仪。该研究作为一项在CPB模拟过程中的体外前瞻性实验研究进行。在生理和极端条件(温度、氧合和血液浓度方面)下,测试了BMU 40在监测动脉血氧分压(pO2)、氧饱和度(SO2)和血细胞比容(Hct)方面的可靠性。进行了四项不同测试,每项测试使用五个传感器。进行了相关性分析和布兰德 - 奥特曼分析。总共比较了350个测量点。所有监测的血液参数值与实验室值高度相关(所有r值>.90)。测试1:实际pO2的偏差范围为 -3.24 mmHg(±6.86 mmHg)至6.0 mmHg(±17.89 mmHg)。37℃时pO2的偏差范围为 -3.52 mmHg(±6.01 mmHg)至68.8 mmHg(±67.82 mmHg)。测试2:Hct的偏差标准差(SD)范围为 -0.35%(±0.79%)至2.35%(±0.91%)。SO2的偏差(SD)范围为 -0.45%(±0.86%)至0.85%(±1.01%)。测试3:Hct的偏差(SD)范围为 -1.00%(±1.84%)至 -0.67%(±1.49%)。测试4:SO2的偏差(SD)范围为 -0.36%(±1.60%)至0.48%(±0.90%)。在模拟CPB的正常生理和极端条件(温度、氧合和血液浓度方面)下,BMU 40是一种可靠的测量动脉血氧分压(pO2)、SO2和Hct的设备。低温条件下计算37℃时pO2的算法需要调整。(在正式上市前,已开发出BMU 40的新软件版本。改进了低温条件下计算37℃时pO2的算法并消除了误算。)