Intensive Care Unit, Exempla St Joseph Hospital, Denver, Colorado 80218, USA.
Am J Crit Care. 2010 Nov;19(6):511-21. doi: 10.4037/ajcc2010502.
To determine if the monitor cursor-line feature on bedside monitors is accurate for measuring central venous and pulmonary artery pressures in cardiac surgery patients.
Central venous and pulmonary artery pressures were measured via 3 methods (end-expiratory graphic recording, monitor cursor-line display, and monitor digital display) in a convenience sample of postoperative cardiac surgery patients. Pressures were measured twice during both mechanical ventilation and spontaneous breathing. Analysis of variance was used to determine differences between measurement methods and the percentage of monitor pressures that differed by 4 mm Hg or more from the measurement obtained from the graphic recording. Significance level was set at P less than .05.
Twenty-five patients were studied during mechanical ventilation (50 measurements) and 21 patients during spontaneous breathing (42 measurements). Measurements obtained via the 3 methods did not differ significantly for either type of pressure (P > .05). Graphically recorded pressures and measurements obtained via the monitor cursor-line or digital display methods differed by 4 mm Hg or more in 4% and 6% of measurements, respectively, during mechanical ventilation and 4% and 11%, respectively, during spontaneous breathing.
The monitor cursor-line method for measuring central venous and pulmonary artery pressures may be a reasonable alternative to the end-expiratory graphic recording method in hemodynamically stable, postoperative cardiac surgery patients. Use of the digital display on the bedside monitor may result in larger discrepancies from the graphically recorded pressures than when the cursor-line method is used, particularly in spontaneously breathing patients.
确定床边监护仪上的光标线功能是否能准确测量心脏外科手术后患者的中心静脉压和肺动脉压。
对术后心脏外科患者进行方便样本测量，使用 3 种方法（呼气末图形记录、监护仪光标线显示和监护仪数字显示）测量中心静脉压和肺动脉压。在机械通气和自主呼吸期间分别进行两次测量。方差分析用于确定测量方法之间的差异，以及有多少比例的监护仪压力与图形记录获得的测量值相差 4mmHg 或以上。显著水平设定为 P 小于.05。
在机械通气期间对 25 名患者进行了研究（50 次测量），在自主呼吸期间对 21 名患者进行了研究（42 次测量）。对于这两种压力，通过这 3 种方法获得的测量值均无显著差异（P >.05）。在机械通气期间，图形记录压力与通过监护仪光标线或数字显示方法获得的测量值相差 4mmHg 或以上的比例分别为 4%和 6%，在自主呼吸期间，这一比例分别为 4%和 11%。
在血流动力学稳定的心脏外科术后患者中，使用监护仪光标线方法测量中心静脉压和肺动脉压可能是呼气末图形记录方法的合理替代方法。与使用光标线方法相比，使用床边监护仪的数字显示可能会导致与图形记录压力的差异更大，尤其是在自主呼吸患者中。
