Shimizu H, Seki S, Mizuguchi A, Tsuchida H, Watanabe H, Namiki A
Department of Anesthesiology, Sapporo Medical College.
Masui. 1990 Apr;39(4):508-12.
The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients.
在接受冠状动脉搭桥手术的成年患者（n = 12）中，对通过阻抗心动描记法（NCCOM3）进行的心输出量监测进行了评估。将通过阻抗心动描记法测量的心输出量值与通过热稀释法测量的值进行比较。还研究了在体外循环（CPB）前后用作胸液量指标的基础阻抗水平的变化。在麻醉诱导期间，热稀释法与阻抗心动描记法获得的值的相关系数（r）为0.79，平均差异为1.29±16.9（标准差）%。在手术期间，r为0.83，平均差异为-14.6±18.7%。除了使用电灼时，阻抗心动描记法的测量可以在整个手术过程中进行。CPB前的基础阻抗水平与CPB后的相比显著降低。基础阻抗水平与中心静脉压（CVP）之间存在负相关。没有患者表现出任何提示肺水肿的迹象，并且CVP、肺动脉压和血气分析的所有值均在正常范围内。从本研究结果得出结论，阻抗心动描记法的心输出量监测在心脏手术中是有用的，但对于基础阻抗的数值与患者临床状态之间的关系还需要进一步详细检查。
