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心脏手术条件变化期间两种肺动脉混合静脉血氧饱和度导管的比较。

A comparison of two pulmonary artery mixed venous oxygen saturation catheters during the changing conditions of cardiac surgery.

作者信息

Hecker B R, Brown D L, Wilson D

机构信息

Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA 98111.

出版信息

J Cardiothorac Anesth. 1989 Jun;3(3):269-75. doi: 10.1016/0888-6296(89)90106-3.

Abstract

Continuous mixed venous oxygen saturation (SvO2), using modified pulmonary artery (PA) catheters, can assist in the management of cardiac surgery patients. Two FDA-approved catheters are available for SvO2 monitoring. One system uses two wavelengths of light and the other is a three-wavelength system. The present study was designed to determine the accuracy of the two catheters during cardiac surgery. Sixty-five consecutive patients were assigned to one of the two catheter groups. Data were collected pre- and post-induction, after sternotomy, and after extracorporeal circulation. An updated hematocrit was entered in the two-wavelength system preceding the last two measurements. Patient demographics, severity of preoperative cardiac disease, and intraoperative hemodynamics were comparable between groups. Two-wavelength determinations varied inconsistently from cooximeter values, while three-wavelength measurements did not differ significantly. Changes in hematocrit were responsible in part for the variability in two-wavelength measurements. In summary, three-wavelength measurements by the Shaw system were more accurate than two-wavelength measurements by the Edwards system.

摘要

使用改良肺动脉(PA)导管连续监测混合静脉血氧饱和度(SvO2),有助于心脏手术患者的管理。美国食品药品监督管理局(FDA)批准的用于监测SvO2的导管有两种。一种系统使用两个波长的光,另一种是三波长系统。本研究旨在确定这两种导管在心脏手术期间的准确性。65例连续患者被分配到两个导管组中的一组。在诱导前和诱导后、胸骨切开术后以及体外循环后收集数据。在最后两次测量之前,将更新的血细胞比容输入双波长系统。两组患者的人口统计学特征、术前心脏病严重程度和术中血流动力学情况具有可比性。双波长测定结果与血气分析仪的值不一致,而三波长测量结果无显著差异。血细胞比容的变化部分导致了双波长测量结果的变异性。总之,Shaw系统的三波长测量比Edwards系统的双波长测量更准确。

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