Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Anaesthesia. 2013 Nov;68(11):1156-60. doi: 10.1111/anae.12422. Epub 2013 Sep 23.
Cardiac output can be measured non-invasively using supra-sternal Doppler (USCOM, Sydney, NSW, Australia). However, scanning can be difficult in practice in older patients, the reason for which has not been elucidated previously. Chest radiographs from 60 previously studied anaesthetised patients were reviewed and scored for aortic unfolding, enlargement and calcification, and cardiac enlargement. Corresponding supra-sternal Doppler scans were graded as easy or difficult using the Cattermole scoring system. Twenty patients who were difficult to scan, aged 60-88 years, had mean (SD) radiological scores of 5.9 (2.5) out of 12, while 20 adult controls, 40-60 years, and 20 older patients who were easy to scan, 60-80 years, had radiological scores of 0.9 (1.1) and 1.7 (1.4), respectively (p < 0.001). Over 75% of the patients who were difficult to scan had two or more radiological features suggestive of aortic unfolding and cardiac enlargement. Morphological or anatomical changes associated with ageing within the upper chest play an important part in the success of using supra-sternal Doppler in older patients.
心输出量可以使用胸骨上多普勒（USCOM，悉尼，新南威尔士州，澳大利亚）进行非侵入性测量。然而，在实际操作中，在老年患者中进行扫描可能会很困难，其原因以前尚未阐明。回顾了 60 名先前接受过麻醉研究的患者的胸部 X 光片，并对主动脉展开、增大和钙化以及心脏增大进行评分。使用 Cattermole 评分系统对胸骨上多普勒扫描进行了简单或困难的分级。20 名难以扫描的 60-88 岁患者的平均（SD）放射学评分为 12 分中的 5.9（2.5），而 20 名年龄在 40-60 岁的成年对照组和 20 名年龄在 60-80 岁的容易扫描的老年患者的放射学评分为 0.9（1.1）和 1.7（1.4）（p<0.001）。超过 75%的难以扫描的患者有两个或更多提示主动脉展开和心脏增大的放射学特征。上胸部与年龄相关的形态或解剖变化在胸骨上多普勒在老年患者中的成功应用中起着重要作用。
