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[全身麻醉期间血流动力学参数的无创监测]

[Non-invasive monitoring of hemodynamic profile during general anesthesia].

作者信息

Muchada R, Rinaldi A, Cathignol D

机构信息

Département d'Anesthésie et Réanimation, Clinique Mutualiste E. André, Lyon, France.

出版信息

Minerva Anestesiol. 1990 Jun;56(6):199-205.

PMID:2280845
Abstract

This article presents a general vision of a new non-invasive cardiovascular monitoring technique applied to patients during general anaesthesia. This method employs an esophageal eco-Doppler, able to supply a continuous measurement of the aortic diameter (eco-TM) and of the velocity of aortic blood flow (pulsed Doppler) for the calculation of aortic output; a monitor to survey the ECG and a noninvasive device for the measurement of blood pressure. The resulting data, opportunely processed by the computer, supply the values of aortic output, of systemic peripheral resistances and of stroke volume. The last two parameters are indexed with aortic output. Through the computer analysis of ECG and of the aortic velocity curve, it is possible to trace back the systolic time intervals and find out the left ventricular ejection time, the pre-ejection period and the electromechanical systole. All these values are indexed with heart rate. The validation of this method gave good results. The comparison between aortic output, measured by the eco-Doppler, and the value obtained with the thermodilution gave a correlation of r = 0.97, and comparing it with the one obtained with the electromagnetic ring, the correlation was r = 0.96. The aortic diameter was calculated with computerized tomography and the correlation between the two diameters resulted in 0.978. This method is quite useful because it supplies continuous parameters in an automatic and noninvasive way. Therefore it is possible, through a compete hemodynamic profile, to diagnose the variations and control the evolutions of the hemodynamic profile induced by the therapeutical treatments, on the basis of a correct physiopathological interpretation.

摘要

本文介绍了一种应用于全身麻醉患者的新型无创心血管监测技术的总体设想。该方法采用食管超声多普勒,能够连续测量主动脉直径(超声心动图-时间测量法)和主动脉血流速度(脉冲多普勒)以计算主动脉输出量;一个用于监测心电图的监护仪和一个无创血压测量装置。所得数据经计算机适当处理后,可提供主动脉输出量、全身外周阻力和每搏输出量的值。后两个参数以主动脉输出量为指标。通过对心电图和主动脉速度曲线的计算机分析,可以追溯收缩期时间间隔并找出左心室射血时间、射血前期和机电收缩期。所有这些值都以心率为指标。该方法的验证取得了良好的结果。超声多普勒测量的主动脉输出量与热稀释法测得的值之间的相关性为r = 0.97,与电磁环法测得的值相比,相关性为r = 0.96。主动脉直径通过计算机断层扫描计算得出,两者之间的相关性为0.978。该方法非常有用,因为它能以自动且无创的方式提供连续参数。因此,基于正确的生理病理解释,通过完整的血流动力学概况,有可能诊断治疗引起的血流动力学变化并控制其演变。

相似文献

1
[Non-invasive monitoring of hemodynamic profile during general anesthesia].[全身麻醉期间血流动力学参数的无创监测]
Minerva Anestesiol. 1990 Jun;56(6):199-205.
2
[Noninvasive hemodynamic monitoring via the integration of data obtained by ECG, aortic flow by Doppler esophageal probe and by finger plethysmography].[通过整合心电图、多普勒食管探头测量的主动脉血流和手指体积描记法获得的数据进行无创血流动力学监测]
Minerva Anestesiol. 1990 May;56(5):147-52.
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[Noninvasive measurement of cardiac output using two-dimensional Doppler echocardiography and analysis of sources of error].[使用二维多普勒超声心动图无创测量心输出量及误差来源分析]
J Cardiol. 1987 Mar;17(1):139-48.
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[Intraoperative determination of heart time volume with transesophageal pulsed Doppler echocardiography].[经食管脉冲多普勒超声心动图术中测定心脏每搏量]
Anaesthesist. 1988 Jun;37(6):345-55.
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Modelflow: a new method for noninvasive assessment of cardiac output in pregnant women.模型血流动力学:一种无创评估孕妇心输出量的新方法。
Am J Obstet Gynecol. 2007 Mar;196(3):235.e1-8. doi: 10.1016/j.ajog.2006.10.896.
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Non-invasive monitoring of hemodynamic changes during hemodialysis by the use of a newly developed admittance cardiograph.使用新开发的导纳心动图仪对血液透析过程中的血流动力学变化进行无创监测。
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[Anaesthesia for a non cardiac surgery in a patient with an Eisenmenger syndrome. Interest of a non invasive haemodynamic monitoring].[艾森曼格综合征患者非心脏手术的麻醉。无创血流动力学监测的意义]
Ann Fr Anesth Reanim. 2006 Feb;25(2):197-200. doi: 10.1016/j.annfar.2005.09.004. Epub 2005 Nov 2.
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[Measurement of cardiac output by Doppler echocardiography: clinical validation in pediatric patients after open heart surgery].[经食管超声心动图测量心输出量:心脏直视手术后儿科患者的临床验证]
Kyobu Geka. 1993 Mar;46(3):210-4.
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Contrast-enhanced Doppler hemodynamics for noninvasive assessment of patients with chronic heart failure and left ventricular systolic dysfunction.对比增强多普勒血流动力学用于慢性心力衰竭和左心室收缩功能障碍患者的无创评估。
J Am Soc Echocardiogr. 2003 Feb;16(2):124-31. doi: 10.1067/mje.2003.8.

引用本文的文献

1
Simultaneous monitoring of noninvasive hemodynamic profile and capnography for tissue perfusion evaluation.同时监测无创血流动力学参数和二氧化碳图以评估组织灌注。
J Anesth. 1994 Dec;8(4):400-405. doi: 10.1007/BF02514616.
2
Non-invasive continuous haemodynamic and PETCO2 monitoring during peroperative cardiac arrest.术中心脏骤停期间的无创连续血流动力学和呼气末二氧化碳监测。
Can J Anaesth. 1995 Oct;42(10):910-3. doi: 10.1007/BF03011039.