Aya Hollmann D, Rhodes Andrew, Fletcher Nick, Grounds R Michael, Cecconi Maurizio
Intensive Care Directorate, St George's University Hospitals NHS Foundation Trust and St George's University of London, Blackshaw road, Tooting, London, SW17 0QT, UK.
J Clin Monit Comput. 2016 Feb;30(1):55-61. doi: 10.1007/s10877-015-9682-y. Epub 2015 Mar 7.
Transient stop-flow arm arterial-venous equilibrium pressure (Pmsf-arm) is a validated technique for measuring the mean systemic filling pressure (Pmsf). Pmsf is a functional measure of the effective intravascular volume status. This study aims to assess the precision of the Pmsf-arm measurement. Pmsf-arm was measured by inflating a pneumatic tourniquet around the upper arm 50 mmHg above systolic pressure for 60 s, four times consecutively, with an interval of 5 min. Arterial (Pa) and venous pressure (Pv) were recorded every 10 s. Pa-Pv difference was calculated to determine the stop-flow time. The coefficient error (CE) was determined and used to derive the least significant change (LSC) in Pmsf-arm that this technique could reliably detect. The rANOVA test was used to compare repeated measurements of the four determinations of Pmsf-arm. 80 measurements of Pmsf-arm were studied in 20 patients. Pa and Pv equalised after 60 s of inflation (Pa-Pv difference 0 ± 0.01 mmHg). There were no significant differences of Pmsf-arm values among determinations. For a single measurement, the CE was 5 % (±2 %) and the LSC was 14 % (±5 %). Averaging two, three and four measurements the CE improves to 4 % (±1 %), 3 % (±1 %) and 3 % (±1 %) respectively, and the LSC was reduced to 10 % (±4 %), 8 % (±3 %) and 7 % (±3 %) respectively. One measurement of Pmsf-arm can reliably detect changes on Pmsf-arm of 14 %. The precision of Pmsf-arm technique improves when averaging two or three measurements.
短暂停流臂动脉 - 静脉平衡压力（Pmsf - arm）是一种用于测量平均体循环充盈压（Pmsf）的有效技术。Pmsf是有效血管内容量状态的一种功能性指标。本研究旨在评估Pmsf - arm测量的精度。通过在上臂周围充气止血带至收缩压以上50 mmHg持续60秒，连续进行4次，间隔5分钟来测量Pmsf - arm。每10秒记录动脉压（Pa）和静脉压（Pv）。计算Pa - Pv差值以确定停流时间。确定系数误差（CE）并用于推导该技术能够可靠检测到的Pmsf - arm的最小显著变化（LSC）。使用重复测量方差分析（rANOVA）测试来比较Pmsf - arm的四次测定的重复测量值。对20名患者进行了80次Pmsf - arm测量。充气60秒后Pa和Pv达到平衡（Pa - Pv差值为0±0.01 mmHg）。各测定之间Pmsf - arm值无显著差异。对于单次测量，CE为5%（±2%），LSC为14%（±5%）。平均进行两次、三次和四次测量时，CE分别提高到4%（±1%）、3%（±1%）和3%（±-1%），LSC分别降至10%（±4%）、8%（±3%）和7%（±3%）。单次测量Pmsf - arm能够可靠地检测到Pmsf - arm 14%的变化。平均进行两次或三次测量时，Pmsf - arm技术的精度会提高。
