School of Life Sciences, Kingston University, Surrey, UK.
Physiol Meas. 2012 Oct;33(10):1691-701. doi: 10.1088/0967-3334/33/10/1691. Epub 2012 Sep 18.
The aim of this study was to evaluate the use of pulse contour analysis calibrated with lithium dilution in a single device (LiDCO) for measurement of cardiac output (Q) during exercise in healthy volunteers. We sought to; (a) compare pulse contour analysis (PulseCO) and lithium indicator dilution (LiDCO) for the measurement of Q during exercise, and (b) assess the requirement for recalibration of PulseCO with LiDCO during exercise. Ten trained males performed multi-stage cycling exercise at intensities below and above ventilatory threshold before constant load maximal exercise to exhaustion. Uncalibrated PulseCO Q (Qraw) was compared to that calibrated with lithium dilution at baseline Qbaseline, during submaximal exercise below (Qlow) and above (Qhigh) ventilatory threshold, and at each exercise stage individually (Qexercise). There was a significant difference between Qbaseline and all other calibration methods during exercise, but not at rest. No significant differences were observed between other methods. Closest agreement with Qexercise was observed for Qhigh (bias ± limits of agreement: 4.8 ± 30.0%). The difference between Qexercise and both Qlow and Qraw was characterized by low bias (4-7%) and wide limits of agreement (> ± 40%). Calibration of pulse contour analysis with lithium dilution prior to exercise leads to a systematic overestimation of exercising cardiac output. A single calibration performed during exercise above the ventilatory threshold provided acceptable limits of agreement with an approach incorporating multiple calibrations throughout exercise. Pulse contour analysis may be used for Q measurement during exercise providing the system is calibrated during exercise.
本研究旨在评估单台设备（LiDCO）使用锂稀释法校准的脉搏轮廓分析（PulseCO）用于测量健康志愿者运动时的心输出量（Q）。我们旨在：（a）比较脉搏轮廓分析（PulseCO）和锂指示剂稀释（LiDCO）在运动时测量 Q 的效果，以及（b）评估在运动期间使用 LiDCO 重新校准 PulseCO 的要求。10 名训练有素的男性在恒负荷最大运动至力竭前，在低于和高于通气阈的多阶段循环运动中进行。未校准的脉搏轮廓分析 Q（Qraw）与基线 Qbaseline 时用锂稀释校准的 Q 进行比较，在低于（Qlow）和高于（Qhigh）通气阈的亚最大运动时以及在每个运动阶段单独进行比较（Qexercise）。在运动期间，Qbaseline 与所有其他校准方法之间存在显著差异，但在休息时则没有。其他方法之间没有观察到显著差异。与 Qexercise 最接近的是 Qhigh（偏倚±一致性界限：4.8 ± 30.0％）。与 Qlow 和 Qraw 相比，Qexercise 的差异特征为低偏倚（4-7％）和宽一致性界限（> ± 40％）。在运动前用锂稀释法校准脉搏轮廓分析会导致运动心输出量的系统高估。在通气阈以上的运动期间进行单次校准可与在整个运动过程中进行多次校准的方法提供可接受的一致性界限。脉搏轮廓分析可用于测量运动时的 Q，前提是在运动期间对系统进行校准。
