Bednarski P, Siclari F, Voigt A, Demertzis S, Lau G
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, FRG.
Crit Care Med. 1990 Oct;18(10):1061-5. doi: 10.1097/00003246-199010000-00002.
This study evaluates the clinical applicability of administering sodium nitroprusside by a closed-loop titration system compared with a manually adjusted system. The mean arterial pressure (MAP) was registered every 10 and 30 sec during the first 150 min after open heart surgery in 20 patients (group 1: computer regulation) and in ten patients (group 2: manual regulation). The results (16,343 and 2,912 data points in groups 1 and 2, respectively), were then analyzed in four time frames and five pressure ranges to indicate clinical efficacy. Sixty percent of the measured MAP in both groups was within the desired +/- 10% during the first 10 min. Thereafter until the end of observation, the MAP was maintained within +/- 10% of the desired set-point 90% of the time in group 1 vs. 60% of the time in group 2. One percent and 11% of data points were +/- 20% from the set-point in groups 1 and 2, respectively (p less than .05, chi-square test). The computer-assisted therapy provided better control of MAP, was safe to use, and helped to reduce nursing demands.
本研究评估了与手动调节系统相比，闭环滴定系统给予硝普钠的临床适用性。在20例患者（第1组：计算机调节）和10例患者（第2组：手动调节）心脏直视手术后的前150分钟内，每10秒和30秒记录一次平均动脉压（MAP）。然后在四个时间框架和五个压力范围内分析结果（第1组和第2组分别有16343个和2912个数据点），以表明临床疗效。在最初10分钟内，两组中60%的测量MAP在所需的±10%范围内。此后直至观察结束，第1组中90%的时间内MAP维持在所需设定点的±10%范围内，而第2组为60%。第1组和第2组分别有1%和11%的数据点与设定点相差±20%（p<0.05，卡方检验）。计算机辅助治疗能更好地控制MAP，使用安全，并有助于减少护理需求。
