Wong D H, Mahutte C K
Department of Anesthesiology, Veterans Administration Medical Center, Long Beach, CA 90822.
Crit Care Med. 1990 Apr;18(4):433-7. doi: 10.1097/00003246-199004000-00017.
Two observers used two-beam pulsed Doppler ultrasound, equipped with a suprasternal probe, to measure cardiac output (QtDopp) in 38 ICU patients who had pulmonary artery catheters and in 20 adult volunteers. The two-beam pulsed Doppler method enables one device to measure simultaneously both aortic blood velocity and aortic diameter. Each observer was blind to the other's measurement and to the thermodilution cardiac output measurement (Qttd). Linear regression of the mean of both observer's QtDopp on Qttd showed QtDopp = 0.90.Qttd + 0.01 (see = 1.54 L/min, r = .90). Bias (+/- SD), defined as mean (QtDopp - Qttd) difference, was -0.69 +/- 1.55 L/min. Interobserver agreement was more variable in patients than volunteers; mean (observer 1 - observer 2) difference was 0.14 +/- 1.30 L/min in ICU patients and -0.09 +/- 0.92 L/min in volunteers. Two-beam pulsed Doppler ultrasound is a simpler method of measuring QtDopp than previous pulsed Doppler methods which measure separately the aortic diameter by echocardiography. Although its agreement with Qttd is close to other Doppler methods and has acceptable interobserver reproducibility, its accuracy remains operator-dependent.
两名观察者使用配备胸骨上探头的双束脉冲多普勒超声，对38名插有肺动脉导管的重症监护病房（ICU）患者和20名成年志愿者测量心输出量（QtDopp）。双束脉冲多普勒方法使一台设备能够同时测量主动脉血流速度和主动脉直径。每位观察者对对方的测量结果以及热稀释法心输出量测量结果（Qttd）均不知情。两位观察者的QtDopp均值与Qttd的线性回归显示QtDopp = 0.90.Qttd + 0.01（标准误 = 1.54 L/分钟，r = 0.90）。偏差（±标准差）定义为（QtDopp - Qttd）的平均差值，为 -0.69 ± 1.55 L/分钟。患者间观察者一致性比志愿者的变化更大；ICU患者中观察者1与观察者2的平均差值为0.14 ± 1.30 L/分钟，志愿者中为 -0.09 ± 0.92 L/分钟。与之前通过超声心动图分别测量主动脉直径的脉冲多普勒方法相比，双束脉冲多普勒超声是一种更简单的测量QtDopp的方法。尽管其与Qttd的一致性接近其他多普勒方法，且观察者间具有可接受的重复性，但其准确性仍依赖于操作者。
