Muchada R, Rinaldi A, Cathignol D
Département d'Anesthésie et Réanimation, Clinique Mutualiste E. André, Lyon, France.
Minerva Anestesiol. 1990 Jun;56(6):199-205.
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.
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。