三尖瓣反流患者中热稀释法对心输出量的低估。

Underestimation of cardiac output by thermodilution in patients with tricuspid regurgitation.

作者信息

Cigarroa R G, Lange R A, Williams R H, Bedotto J B, Hillis L D

机构信息

Department of Internal Medicine (Cardiovascular Division), University of Texas Southwestern Medical Center, Dallas 75235.

出版信息

Am J Med. 1989 Apr;86(4):417-20. doi: 10.1016/0002-9343(89)90339-2.

DOI:10.1016/0002-9343(89)90339-2

PMID:2648822

Abstract

INTRODUCTION

This study was done to assess the accuracy and reliability of the thermodilution technique in measuring cardiac output in patients with tricuspid regurgitation.

PATIENTS AND METHODS

In 30 subjects (17 men, 13 women, aged 50 +/- 14 [mean +/- SD] years), cardiac output was measured in close temporal proximity by thermodilution as well as Fick or indocyanine green dye, after which the presence and severity of tricuspid regurgitation were assessed by contrast right ventriculography or pulsed Doppler echocardiography.

RESULTS

In the 13 patients without tricuspid regurgitation, there was excellent agreement between the results of thermodilution and Fick or indocyanine green dye cardiac output determinations (4.95 +/- 1.19 liters/minute by thermodilution, 4.90 +/- 1.11 liters/minute by Fick or indocyanine green dye; NS). In contrast, in the 17 patients with tricuspid regurgitation, the results of thermodilution were consistently lower than those of Fick or indocyanine green dye (4.22 +/- 1.45 liters/minute by thermodilution, 4.99 +/- 1.67 liters/minute by Fick or indocyanine green dye; p less than 0.001).

CONCLUSION

Thus, the thermodilution technique of measuring cardiac output is inaccurate in patients with tricuspid regurgitation, yielding results that are consistently lower than the actual outputs.

摘要

引言

本研究旨在评估热稀释技术在测量三尖瓣反流患者心输出量时的准确性和可靠性。

患者与方法

在30名受试者（17名男性，13名女性，年龄50±14[平均±标准差]岁）中，通过热稀释法以及Fick法或吲哚菁绿染料法在短时间内测量心输出量，之后通过右心室造影或脉冲多普勒超声心动图评估三尖瓣反流的存在及严重程度。

结果

在13名无三尖瓣反流的患者中，热稀释法与Fick法或吲哚菁绿染料法测定的心输出量结果高度一致（热稀释法为4.95±1.19升/分钟，Fick法或吲哚菁绿染料法为4.90±1.11升/分钟；无显著性差异）。相比之下，在17名有三尖瓣反流的患者中，热稀释法的结果始终低于Fick法或吲哚菁绿染料法（热稀释法为4.22±1.45升/分钟，Fick法或吲哚菁绿染料法为4.99±1.67升/分钟；p<0.001）。