Jansen J R, Wesseling K H, Settels J J, Schreuder J J
Department of Pulmonary Diseases, Erasmus University, Rotterdam, The Netherlands.
Eur Heart J. 1990 Dec;11 Suppl I:26-32. doi: 10.1093/eurheartj/11.suppl_i.26.
Most pulse contour methods are unreliable under changing haemodynamic conditions, because no corrections are made for pressure-dependent compliance and reflections of pressure waves. The pulse contour method of Wesseling includes such corrections. Four thermodilution measurements equally spread over the ventilatory cycle were used to calibrate and evaluate this pulse contour method. We designed a prototype incorporating a combination of the thermodilution method and pulse contour method and evaluated its potential for monitoring patients undergoing coronary bypass graft operation. Eight to 12 times during the operation, cardiac output was estimated by pulse contour and by thermodilution. The results were compared: the linear regression between the methods was COpc = 0.3 + 0.94. COth, (r = 0.94). The standard deviation for the difference between the methods against the mean of the methods was 10.6%. We concluded that the corrected pulse contour method estimates cardiac output accurately, even when heart rate, blood pressure, and total peripheral resistance change substantially.
大多数脉搏轮廓法在血流动力学条件变化时不可靠，因为未对压力依赖性顺应性和压力波反射进行校正。韦塞尔林的脉搏轮廓法包括此类校正。在通气周期内等间隔进行的四次热稀释测量用于校准和评估此脉搏轮廓法。我们设计了一个结合热稀释法和脉搏轮廓法的原型，并评估了其用于监测冠状动脉搭桥手术患者的潜力。在手术过程中，通过脉搏轮廓法和热稀释法对心输出量进行了8至12次估计。对结果进行了比较：两种方法之间的线性回归为COpc = 0.3 + 0.94COth，（r = 0.94）。两种方法差值相对于方法均值的标准差为10.6%。我们得出结论，即使心率、血压和总外周阻力发生显著变化，校正后的脉搏轮廓法仍能准确估计心输出量。
