Grant R P, Morgan C, Page M S, Malm D N, Huckel V, Jenkins L C
Department of Anaesthesiology, Faculty of Medicine, University of British Columbia, Vancouver.
Can J Anaesth. 1990 May;37(4 Pt 1):409-15. doi: 10.1007/BF03005616.
Dipyridamole thallium scanning (DTS) is an imaging technique with good sensitivity for coronary artery disease (CAD). The purpose of this study was to compare the haemodynamic courses and the correlation between pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) in patients with normal DTS (Group 1: n = 12) with those whose scans demonstrated CAD (Group 2: n = 11). Haemodynamic profiles were obtained prior to anaesthesia and at several times during surgery. The haemodynamic courses in both groups were similar with significant decreases in cardiac index, stroke index, and left ventricular stroke work index during aortic cross-clamping compared with values prior to anaesthesia. There were no significant changes in PCWP and CVP throughout the study. The correlations between PCWP and CVP were significant in both groups as were the correlations between the changes in PCWP and the changes in CVP observed at the time of cross-clamping. These correlations all had large standard errors of the estimate, however, making it impossible to predict the PCWP from the CVP with precision. It is concluded that, in a limited study population, an abnormal DTS did not identify patients in whom the PCWP and CVP correlated poorly during abdominal aortic aneurysmectomy.
双嘧达莫铊扫描(DTS)是一种对冠状动脉疾病(CAD)具有良好敏感性的成像技术。本研究的目的是比较DTS正常患者(第1组:n = 12)与扫描显示CAD患者(第2组:n = 11)的血流动力学过程以及肺毛细血管楔压(PCWP)与中心静脉压(CVP)之间的相关性。在麻醉前及手术期间的几个时间点获取血流动力学参数。两组的血流动力学过程相似,与麻醉前的值相比,主动脉交叉钳夹期间心脏指数、每搏指数和左心室每搏功指数显著降低。在整个研究过程中,PCWP和CVP没有显著变化。两组中PCWP与CVP之间的相关性均显著,交叉钳夹时观察到的PCWP变化与CVP变化之间的相关性也显著。然而,这些相关性的估计标准误差都很大,因此无法根据CVP精确预测PCWP。得出的结论是,在有限的研究人群中,异常的DTS并不能识别出在腹主动脉瘤切除术中PCWP与CVP相关性较差的患者。