Pugsley Jacob, Lerner Adam B
Beth Israel Deaconess Medical Center, Boston, MA, USA.
Semin Cardiothorac Vasc Anesth. 2010 Dec;14(4):274-82. doi: 10.1177/1089253210386386. Epub 2010 Nov 7.
As a principal determinant of oxygen delivery and of blood pressure, cardiac output (CO) represents an important hemodynamic variable. Its accurate measurement, therefore, is important to the clinician caring for critically ill patients in a variety of care environments. Though the first clinical measurement of CO occurred 70 years ago, it was the introduction of the pulmonary artery catheter (PAC) with thermodilution-based determination of CO in the 1970s that set the stage for practical and widespread clinical measurement of CO. Although the usefulness and accuracy of this technique have justified its consideration as a "practical" gold standard in CO measurement, its drawbacks have driven the search for newer, less invasive measurement techniques. The last decade has seen the introduction of several such devices into the clinical arena. This article will serve to give a brief review of the history of CO measurement, to provide a discussion of the measurement of accuracy as it relates to CO measurement, and to discuss some of the newer methods and devices for CO measurement and how they have fared against a "practical" gold standard.
作为氧输送和血压的主要决定因素，心输出量（CO）是一个重要的血流动力学变量。因此，其准确测量对于在各种护理环境中照料重症患者的临床医生而言至关重要。尽管首次对心输出量进行临床测量是在70年前，但20世纪70年代肺动脉导管（PAC）的引入以及基于热稀释法的心输出量测定，为心输出量的实际广泛临床测量奠定了基础。尽管该技术的实用性和准确性使其被视为心输出量测量的“实用”金标准，但它的缺点促使人们寻求更新的、侵入性较小的测量技术。在过去十年中，已有几种此类设备进入临床领域。本文将简要回顾心输出量测量的历史，讨论与心输出量测量相关的准确性测量问题，并探讨一些心输出量测量的新方法和设备，以及它们与“实用”金标准相比的表现。
