National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
J Cardiothorac Vasc Anesth. 2012 Apr;26(2):223-6. doi: 10.1053/j.jvca.2011.07.011. Epub 2011 Sep 15.
To compare cardiac output (CO) measurements acquired using the Flotrac/Vigileo system (Edwards Lifesciences, Irvine, CA) and CO measured by transesophageal echocardiography using the product of the aortic valve area, the time integral of flow at the same site, and the heart rate during abdominal aortic aneurysm (AAA) surgery.
A prospective clinical study.
Cardiac surgery operating room of 1 heart center hospital.
Twenty patients undergoing elective AAA surgery.
CO was determined simultaneously using the Flotrac/Vigileo system (CO(AP)) and transesophageal echocardiography (CO(TEE)) as the reference method at 8 time points during AAA surgery.
One hundred sixty simultaneous datasets were obtained. The authors observed a significant correlation between CO(AP) and CO(TEE) values (R = 0.56, p < 0.001). Bland-Altman analysis of CO(AP) and CO(TEE) showed a bias of 0.12 L/min and limits of agreement from -1.66 to 1.90 L/min, with a percentage error of 41%. Just after aortic clamping, CO(AP) significantly increased, but CO(TEE) decreased in comparison with previous measurements. There was a significant association among changes in CO(AP) and pulse pressure, heart rate, and central venous pressure (CVP). However, changes in CO(TEE) were only associated with variations in heart rate.
CO(AP) values were not clinically acceptable for use in AAA surgery because of wide variations during aortic clamping and declamping. Changes in pulse pressure, heart rate, and CVP were associated with significant changes in CO(AP), whereas only changes in heart rate showed associated changes in CO(TEE).
比较使用 Flotrac/Vigileo 系统（爱德华生命科学公司，欧文，加利福尼亚州）测量心输出量（CO）与经胸超声心动图使用主动脉瓣面积、同一部位血流时间积分和心率乘积在腹主动脉瘤（AAA）手术中测量 CO 的结果。
前瞻性临床研究。
1 家心脏中心医院的心脏手术手术室。
20 例行择期 AAA 手术的患者。
在 AAA 手术期间的 8 个时间点，同时使用 Flotrac/Vigileo 系统（CO（AP））和经食管超声心动图（CO（TEE））确定 CO。
共获得 160 对同时数据集。作者观察到 CO（AP）和 CO（TEE）值之间存在显著相关性（R = 0.56，p < 0.001）。CO（AP）和 CO（TEE）的 Bland-Altman 分析显示，偏差为 0.12 L/min，一致性界限为 -1.66 至 1.90 L/min，百分比误差为 41%。在主动脉夹闭后，CO（AP）显著增加，而与之前的测量相比，CO（TEE）下降。CO（AP）的变化与脉压、心率和中心静脉压（CVP）的变化之间存在显著相关性。然而，CO（TEE）的变化仅与心率的变化相关。
由于在主动脉夹闭和松开期间 CO（AP）值的变化较大，因此 CO（AP）值在 AAA 手术中不能被临床接受。脉压、心率和 CVP 的变化与 CO（AP）的显著变化相关，而仅心率的变化与 CO（TEE）的变化相关。
Zotero 插件