Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
J Crit Care. 2014 Apr;29(2):260-4. doi: 10.1016/j.jcrc.2013.11.003. Epub 2013 Nov 7.
Many mini-invasive devices to monitor cardiac output (CO) have been introduced and, among them, the pressure recording analytical method (PRAM). The aim of this study was to assess the agreement of PRAM with the intermittent transpulmonary thermodilution and continuous pulmonary thermodilution in measuring CO in hemodynamically stabilized patients.
This is a prospective clinical study in a mixed medical-surgical intensive care unit (ICU) and in a postcardiac surgical ICU. Forty-eight patients were enrolled: 32 patients to the medical-surgical ICU monitored with PiCCO (Pulsion Medical System AG, Munich, Germany) and 16 were cardiac patients monitored with Vigilance (Edwards Lifesciences, Irvine, CA).
A total of 112 measurements were made. Ninety-six comparisons of paired CO measurements were made in patients hospitalized in medical-surgical ICU; 16, in cardiac surgical patients. The mean Vigilance-CO was 4.49 ± 0.99 L/min (range, 2.80-5.90 L/min), and the mean PRAM-CO was 4.27 ± 0.88 L/min (range, 2.85-6.19 L/min). The correlation coefficient between Vigilance-CO and PRAM-CO was 0.83 (95% confidence interval, 0.57-0.94; P < .001). The bias was 0.22 ± 0.55 L/min with limits of agreement between 0.87 and 1.30 L/min. The percentage error was 25%. Mean TP-CO was 6.78 ± 2.04 L/min (range, 4.12-11.27 L/min), and the mean PRAM-CO was 6.11 ± 2.18 L/min (range, 2.82-10.90 L/min). The correlation coefficient between PiCCO-CO and PRAM-CO was 0.91 (95% confidence interval, 0.83-0.96; P < .0001). The bias was 0.67 ± 0.89 L/min with limits of agreement -1.07 and 2.41 L/min. The coefficient of variation for PiCCO was 4% ± 2%, and the coefficient of variation for PRAM was 10% ± 8%. The percentage error was 28%.
The PRAM system showed good agreement with pulmonary artery catheter and PiCCO in hemodynamically stabilized patients.
许多监测心输出量（CO）的微创设备已经问世，其中包括压力记录分析方法（PRAM）。本研究旨在评估 PRAM 与间歇经肺热稀释法和连续经肺热稀释法在血流动力学稳定患者中测量 CO 的一致性。
这是一项在混合内科-外科重症监护病房（ICU）和心脏手术后 ICU 进行的前瞻性临床研究。共纳入 48 例患者：32 例接受 PiCCO（德国慕尼黑 Pulsion Medical System AG）监测的内科-外科 ICU 患者和 16 例接受 Vigilance（美国加利福尼亚州欧文市爱德华兹生命科学公司）监测的心脏患者。
共进行了 112 次测量。在接受内科-外科 ICU 监测的患者中，对 96 对 CO 配对测量值进行了比较；在心脏外科患者中，对 16 对 CO 配对测量值进行了比较。Vigilance-CO 的平均值为 4.49 ± 0.99 L/min（范围为 2.80-5.90 L/min），PRAM-CO 的平均值为 4.27 ± 0.88 L/min（范围为 2.85-6.19 L/min）。Vigilance-CO 和 PRAM-CO 之间的相关系数为 0.83（95%置信区间为 0.57-0.94；P<0.001）。偏差为 0.22 ± 0.55 L/min，一致性界限为 0.87 和 1.30 L/min。百分比误差为 25%。TP-CO 的平均值为 6.78 ± 2.04 L/min（范围为 4.12-11.27 L/min），PRAM-CO 的平均值为 6.11 ± 2.18 L/min（范围为 2.82-10.90 L/min）。PiCCO-CO 和 PRAM-CO 之间的相关系数为 0.91（95%置信区间为 0.83-0.96；P<0.0001）。偏差为 0.67 ± 0.89 L/min，一致性界限为-1.07 和 2.41 L/min。PiCCO 的变异系数为 4%±2%，PRAM 的变异系数为 10%±8%。百分比误差为 28%。
PRAM 系统在血流动力学稳定的患者中与肺动脉导管和 PiCCO 具有良好的一致性。
Zotero 插件