Yoshitake Shuichi, Miyamoto Takashi, Tanaka Yuki, Naito Yuji
Department of Cardiovascular Surgery, Gunma Children's Medical Center, Gunma, Japan.
Pediatr Int. 2017 Feb;59(2):141-144. doi: 10.1111/ped.13084. Epub 2016 Oct 30.
Electrical velocimetry correlates well with established methods of measuring cardiac output (CO) such as thermodilution and echocardiography. In this study, we compared the cardiac function of children with single right ventricle (SRV) and single left ventricle (SLV) on non-invasive postoperative measurement of hemodynamic parameters using AESCULON mini.
Demographic, preoperative, and perioperative data were obtained from medical records. We retrospectively reviewed the AESCULON mini data of 21 patients with single ventricle who underwent Fontan operation. The patients were divided into two groups according to morphologic diagnosis: SRV (n = 9) and SLV (n = 12). The following hemodynamic parameters were analyzed: stroke volume (SV); CO; cardiac index (CI); stroke volume variation (SVV); and ventricular ejection time (VET).
Hemodynamic parameters were as follows (SRV vs SLV): heart rate (HR), 140.5 beats/min versus 121 beats/min; SV, 14.5 mL vs 19.9 mL; CO, 2 L/min vs 2.3 L/min; CI, 4.3 L/min/m versus 4.4 L/min/m ; SVV, 15.5% versus 13.9%; and VET, 167.7 s versus 197.7 s. HR and VET were statistically different between the two groups.
CI does not differ with laterality of the single ventricle. SRV VET, however, was significantly shorter than SLV VET in the acute postoperative period. Conversely, SRV HR was higher than SLV HR, which may mean that SRV compensates for lower VET by increasing HR.
电测速法与测量心输出量(CO)的既定方法,如热稀释法和超声心动图法,具有良好的相关性。在本研究中,我们使用AESCULON微型设备对单右心室(SRV)和单左心室(SLV)患儿进行无创术后血流动力学参数测量,比较其心功能。
从病历中获取人口统计学、术前和围手术期数据。我们回顾性分析了21例接受Fontan手术的单心室患者的AESCULON微型设备数据。根据形态学诊断将患者分为两组:SRV组(n = 9)和SLV组(n = 12)。分析以下血流动力学参数:每搏输出量(SV)、CO、心脏指数(CI)、每搏输出量变异度(SVV)和心室射血时间(VET)。
血流动力学参数如下(SRV组与SLV组):心率(HR),140.5次/分钟对121次/分钟;SV,14.5毫升对19.9毫升;CO,2升/分钟对2.3升/分钟;CI,4.3升/分钟/平方米对4.4升/分钟/平方米;SVV,15.5%对13.9%;VET,167.7秒对197.7秒。两组间HR和VET有统计学差异。
CI不因单心室的左右侧而异。然而,在术后急性期,SRV的VET明显短于SLV的VET。相反,SRV的HR高于SLV的HR,这可能意味着SRV通过增加HR来补偿较低的VET。