Department of Anesthesiology & Perioperative Care, University of California, Irvine, CA 92868, USA.
J Clin Anesth. 2012 Jun;24(4):275-83. doi: 10.1016/j.jclinane.2011.08.014.
To evaluate the validity of cardiac output (CO) measurements obtained using the Nexfin device in comparison to those obtained with the esophageal Doppler in steady-state conditions and after phenylephrine administration.
Prospective observational study.
Operating room of a North American academic medical center.
25 ASA physical status 1, 2, and 3 patients referred for abdominal or orthopedic surgeries.
After endotracheal intubation, patients who presented with a 20% or greater decrease in mean arterial pressure (MAP) received an intravenous (IV) bolus of 100 μg of phenylephrine. If MAP was still 20% lower than the patient's baseline level at least 10 minutes after the first vasopressor treatment, a second bolus of 100 μg of phenylephrine was given.
CO was measured simultaneously by esophageal Doppler (CO(ED)) and Nexfin (CO(NXF)) at baseline and when blood pressure peaked after an IV 100 μg phenylephrine bolus. Comparisons were then made between the two devices to evaluate the ability of the Nexfin device to track changes in CO.
66 pairs of data were obtained. Mean CO(ED) and CO(NXF) were 4.7 ± 1.8 L/min and 5.6 ± 2.0 L/min, respectively. There was a significant relationship between CO(ED) and CO(NXF) (r(2) = 0.82; P < 0.001). The agreement between CO(ED) and CO(NXF) was 0.88 ± 0.86 L/min (Bland Altman). The mean percent error (Critchley and Critchley) of CO(NXF) versus CO(ED) was 37%. Trending analysis found a 94% concordance between changes in CO(ED) and CO(NXF) after phenylephrine administration.
Intraoperative CO measurement using the Nexfin device has a strong correlation with CO measured by esophageal Doppler.
评估使用 Nexfin 设备测量心输出量（CO）的有效性，与食管多普勒在稳态条件下和苯肾上腺素给药后的测量值进行比较。
前瞻性观察性研究。
北美学术医疗中心的手术室。
25 名 ASA 身体状况 1、2 和 3 级的患者，接受腹部或骨科手术。
在气管插管后，出现平均动脉压（MAP）降低 20%或更多的患者接受静脉注射（IV）100μg苯肾上腺素推注。如果 MAP 在第一次血管加压治疗后至少 10 分钟仍比患者基线水平低 20%，则给予第二次 100μg苯肾上腺素推注。
在基线时和静脉注射 100μg苯肾上腺素推注后血压达到峰值时，通过食管多普勒（CO（ED））和 Nexfin（CO（NXF））同时测量 CO。然后比较两种设备以评估 Nexfin 设备跟踪 CO 变化的能力。
获得了 66 对数据。平均 CO（ED）和 CO（NXF）分别为 4.7±1.8 L/min 和 5.6±2.0 L/min。CO（ED）和 CO（NXF）之间存在显著关系（r²=0.82；P<0.001）。CO（ED）和 CO（NXF）之间的一致性为 0.88±0.86 L/min（Bland Altman）。CO（NXF）与 CO（ED）的平均百分比误差（Critchley 和 Critchley）为 37%。趋势分析发现苯肾上腺素给药后 CO（ED）和 CO（NXF）的变化有 94%的一致性。
使用 Nexfin 设备进行术中 CO 测量与食管多普勒测量的 CO 具有很强的相关性。
