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在急诊分诊环境中使用 Finapres 脉波指示剂连续心排血量监测仪进行无创血压和心排血量测量。

Non-invasive blood pressure and cardiac index measurements using the Finapres Portapres in an emergency department triage setting.

机构信息

Department of emergency medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

Am J Emerg Med. 2013 Jul;31(7):1012-6. doi: 10.1016/j.ajem.2013.03.004. Epub 2013 May 18.

Abstract

UNLABELLED

Emergency department (ED) patients are triaged to determine the urgency of care. The Finapres Portapres (FP) measures blood pressure (BP) and cardiac output (CO) non-invasively, and may be of added value in early detection of patients at risk for hemodynamic compromise.

OBJECTIVES

Compare non-invasive BP measurements using FP and standard automated sphygmomanometry. Compare FP cardiac index (CI), CO corrected for body surface area, of normotensive patients, to chart-based physician estimate of shock, to discover if there is additional value in CI measurements in triage.

METHODS

ED Patients requiring BP measurement in triage were included. Systolic (SBP) and diastolic (DBP) BP were measured using both devices during a two minutes measurement. Two physicians independently judged probability of shock, defined as estimated CI ≤2.5 L min(-1) m(-2), based on chart review, three weeks after ED visit.

RESULTS

Of a total of 112 patients 97 patients were included. Pearson's correlation coefficient was 0.50 for SBP, 0.53 for DBP, with a Blant-Altman mean bias of 11.3 (upper limit 65.3, lower limit -42.8) and 7.7 (39.2, -23.7) for SBP and DBP respectively. In normotensive patients, the group with low FP CI measurements had significantly more cases with physician-estimated shock, compared to the normal to high measurements (P = .036).

CONCLUSIONS

When used as a triage device in the emergency department setting, non-invasive BP measurements using FP do not correlate well with automated sphygmomanometry. However, this study does indicate that use of the FP device in triage may aid physicians to recognize patients in early phases of shock.

摘要

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急诊科(ED)患者进行分诊以确定护理的紧急程度。Finapres Portapres(FP)无创测量血压(BP)和心输出量(CO),并且在早期发现有血流动力学受损风险的患者方面可能具有附加价值。

目的

比较 FP 和标准自动血压计的非侵入性血压测量。比较正常血压患者的 FP 心指数(CI)和校正体表面积的心输出量(CO),与基于图表的医生对休克的估计,以发现分诊时 CI 测量是否具有额外价值。

方法

将需要在分诊时测量血压的 ED 患者纳入研究。在两分钟的测量过程中,使用两种设备测量收缩压(SBP)和舒张压(DBP)。两名医生在 ED 就诊后三周,根据图表回顾,独立判断休克的可能性,定义为估计 CI≤2.5 L min(-1) m(-2)。

结果

总共 112 名患者中,97 名患者被纳入。SBP 的 Pearson 相关系数为 0.50,DBP 的 Pearson 相关系数为 0.53,平均偏差为 11.3(上限 65.3,下限-42.8)和 7.7(39.2,-23.7),SBP 和 DBP 分别为。在正常血压患者中,FP CI 测量值较低的组与正常至高测量值的组相比,有更多的医生估计的休克病例,差异具有统计学意义(P=0.036)。

结论

当在急诊环境中用作分诊设备时,FP 无创血压测量与自动血压计的相关性不佳。然而,本研究确实表明,在分诊中使用 FP 设备可以帮助医生更早地识别休克患者。

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