Sotomi Yohei, Nishiyama Chie, Shimizu Tomoaki, Kita Takashi, Maki Naritoshi, Sasaki Shigeta
Department of Anesthesiology, Osaka Police Hospital, Osaka 543-0035.
Masui. 2011 Feb;60(2):203-7.
Recently, various less-invasive cardiac output monitors are used for a variety of cases. We used FloTrac system for a patient with severe dilated cardiomyopathy (LVDd/Ds = 75/62 mm, EF = 22%) and recognized its limitation. A 52-year-old woman underwent left partial mastectomy. There were no significant events during the operation. In the ICU, she developed symptoms of low output state, but we could not detect any significant changes on Vigileo Monitor. Arterial pressure-based cardiac output (APCO) measurement with FloTrac is based on the patient's characteristics, blood pressure waveform and basic data stored in Vigileo Monitor. Its accuracy is worse with arterial wave artifact, compromise of the arterial catheter, aortic regurgitation, intense peripheral vasoconstriction, irregular pulse and severe cardiac hypofunction. Thus, its reliability is influenced by various conditions, especially in critically ill patients. FloTrac system is very useful for the management of cardiocirculatory dynamics, but we should be familiar with its limitations.
最近，各种微创心输出量监测仪被用于多种病例。我们对一名患有严重扩张型心肌病（左室舒张末期内径/收缩末期内径 = 75/62 mm，射血分数 = 22%）的患者使用了FloTrac系统，并认识到了其局限性。一名52岁女性接受了左半乳房切除术。手术期间未发生重大事件。在重症监护病房，她出现了低输出状态的症状，但我们在Vigileo监测仪上未检测到任何显著变化。使用FloTrac进行的基于动脉压的心输出量（APCO）测量是基于患者的特征、血压波形以及Vigileo监测仪中存储的基本数据。在存在动脉波伪像、动脉导管受损、主动脉瓣反流、强烈的外周血管收缩、不规则脉搏和严重的心功能不全时，其准确性会变差。因此，其可靠性受多种条件影响，尤其是在危重病患者中。FloTrac系统对于心脏循环动力学的管理非常有用，但我们应该熟悉其局限性。
