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经胸电阻抗法与热稀释法测量孕期心输出量:初步报告

Measurement of cardiac output in pregnancy by thoracic electrical bioimpedance and thermodilution. A preliminary report.

作者信息

Masaki D I, Greenspoon J S, Ouzounian J G

机构信息

Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.

出版信息

Am J Obstet Gynecol. 1989 Sep;161(3):680-4. doi: 10.1016/0002-9378(89)90379-7.

Abstract

Thoracic electrical bioimpedance is a noninvasive, continuous method of obtaining cardiac output that requires no operator skill. However, the most recent thoracic electrical bioimpedance technology has not been validated in pregnancy. We therefore compared two methods of measuring cardiac output in pregnancy, thoracic electrical bioimpedance and thermodilution. We studied 11 patients who required pulmonary artery catheterization for peripartum management and measured cardiac output simultaneously by thoracic electrical bioimpedance and thermodilution. Among eight of nine patients, there was agreement (within +/- 20%) between the two methods. Bivariate linear regression with these nine cases showed excellent correlation (r = 0.91, p less than 0.001) with a slope of 1.04, which indicated a one-to-one relationship between thoracic electrical bioimpedance and thermodilution. The remaining two cases were removed from analysis because of septic shock in one case (which invalidates thoracic electrical bioimpedance) and 4+ tricuspid regurgitation in another case (which invalidates thermodilution). These data support that thoracic electrical bioimpedance measurement of cardiac output may be valid in most peripartum patients.

摘要

胸电阻抗是一种无需操作人员技巧的无创、连续获取心输出量的方法。然而,最新的胸电阻抗技术尚未在孕期得到验证。因此,我们比较了孕期测量心输出量的两种方法,即胸电阻抗法和热稀释法。我们研究了11例因围产期管理需要进行肺动脉导管插入术的患者,并通过胸电阻抗法和热稀释法同时测量心输出量。在9例患者中的8例中,两种方法测得的结果一致(误差在±20%以内)。对这9例病例进行双变量线性回归分析显示,二者具有极佳的相关性(r = 0.91,p < 0.001),斜率为1.04,这表明胸电阻抗法和热稀释法之间存在一对一的关系。其余2例被排除在分析之外,原因是其中1例发生感染性休克(这使胸电阻抗法测量结果无效),另1例存在4级三尖瓣反流(这使热稀释法测量结果无效)。这些数据支持在大多数围产期患者中,通过胸电阻抗法测量心输出量可能是有效的。

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