Calbet J A L, Mortensen S P, Munch G D W, Curtelin D, Boushel R
Department of Physical Education, Research Institute of Biomedical and Health Sciences, IUIBS, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Scand J Med Sci Sports. 2016 May;26(5):518-27. doi: 10.1111/sms.12473. Epub 2015 Apr 28.
To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of temperature in the femoral artery were used for CITT-Q assessment. CITT-Q was linearly related to ICG-Q (r = 0.82, CITT-Q = 0.876 × ICG-Q + 3.638, P < 0.001; limits of agreement ranging from -1.43 to 3.07 L/min) and BTD-Q (r = 0.91, CITT-Q = 0.822 × BTD + 4.481 L/min, P < 0.001; limits of agreement ranging from -1.01 to 2.63 L/min). Compared with ICG-Q and BTD-Q, CITT-Q overestimated cardiac output by 1.6 L/min (≈ 10% of the mean ICG and BTD-Q values, P < 0.05). For Q between 20 and 28 L/min, we estimated an overestimation < 5%. The coefficient of variation of 23 repeated CITT-Q measurements was 6.0% (CI: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans.
为了确定人体运动期间持续输注经肺热稀释法心输出量（CITT-Q）评估的准确性和精密度，以吲哚菁绿（ICG）稀释法和团注经肺热稀释法（BTD）作为参考方法，在15名健康男性静息状态下以及在蹬自行车测力计进行单腿和双腿递增蹬踏运动期间以及手臂曲柄运动与腿部蹬踏运动联合进行直至疲劳时测定心输出量（Q）。采用在股静脉持续输注冰盐水（n = 41）或同时在股静脉和腋静脉持续输注冰盐水（n = 66）并测定股动脉温度的方法来评估CITT-Q。CITT-Q与ICG-Q呈线性相关（r = 0.82，CITT-Q = 0.876×ICG-Q + 3.638，P < 0.001；一致性界限为-1.43至3.07 L/min）以及与BTD-Q呈线性相关（r = 0.91，CITT-Q = 0.822×BTD + 4.481 L/min，P < 0.001；一致性界限为-1.01至2.63 L/min）。与ICG-Q和BTD-Q相比，CITT-Q高估心输出量1.6 L/min（约为ICG和BTD-Q均值的10%，P < 0.05）。对于20至28 L/min的心输出量，我们估计高估幅度<5%。23次重复CITT-Q测量的变异系数为6.0%（95%置信区间：6.1 - 11.1%）。总之，在运动的人体中采用持续输注经肺热稀释法能够精确且准确地测定心输出量。
