Kumar A, Minagoe S, Thangathurai D, Mikhail M, Novia D, Viljoen J F, Rahimtoola S H, Chandraratna P A
Department of Medicine, Los Angeles County-University of Southern California Medical Center, University of Southern California School of Medicine 90033.
Am J Cardiol. 1989 Oct 1;64(12):793-8. doi: 10.1016/0002-9149(89)90767-4.
The ability of a new continuous-wave Doppler esophageal probe to measure cardiac output noninvasively during surgery under general anesthesia was tested and compared with simultaneously measured thermodilution cardiac output. A Doppler computer, calibrated for the aortic diameter and the transcutaneously measured cardiac output from the suprasternal notch, computed the Doppler cardiac output from the descending aortic blood flow velocity signal. A total of 246 paired Doppler cardiac output and thermodilution cardiac output measurements were made in 14 patients during surgery. The average thermodilution cardiac output was 5.90 +/- 3.27 (standard deviation) liters/min (range 1.20 to 19.18); the average Doppler cardiac output was 6.21 +/- 4.0 liters/min (range 2.30 to 28.20). The difference between the cardiac output measured by the 2 techniques was 1.38 +/- 2.2 liters/min (range 0.04 to 16.8). Two to 5 cardiac output measurements were averaged and arranged into "time periods." The average standard deviations for thermodilution and Doppler cardiac outputs within each time period were 0.64 and 0.47 liters/min, respectively. There was a correlation between the 2 measurements over a range of cardiac output values (r = 0.76, Doppler cardiac output = 0.93 x thermodilution cardiac output +0.7, standard error of the estimate = 1.76). Reproducible measurements of Doppler cardiac output were obtained during intraobserver (mean difference 0.64 +/- 0.52 liter/min) and interobserver (mean difference 0.41 +/- 0.36 liter/min) studies (n = 8). Cardiac output measurement by the Doppler esophageal probe could be used for hemodynamic monitoring during surgery in selected patients with cardiopulmonary disease.
对一种新型连续波多普勒食管探头在全身麻醉下手术期间无创测量心输出量的能力进行了测试，并与同时测量的热稀释法心输出量进行了比较。一台针对主动脉直径和经胸骨上切迹经皮测量的心输出量进行校准的多普勒计算机，根据降主动脉血流速度信号计算多普勒心输出量。在14例患者手术期间共进行了246对多普勒心输出量和热稀释法心输出量的测量。热稀释法心输出量的平均值为5.90±3.27（标准差）升/分钟（范围1.20至19.18）；多普勒心输出量的平均值为6.21±4.0升/分钟（范围2.30至28.20）。两种技术测量的心输出量差异为1.38±2.2升/分钟（范围0.04至16.8）。将2至5次心输出量测量结果进行平均并划分为“时间段”。每个时间段内热稀释法和多普勒心输出量的平均标准差分别为0.64升/分钟和0.47升/分钟。在一定的心输出量值范围内，两种测量方法之间存在相关性（r = 0.76，多普勒心输出量 = 0.93×热稀释法心输出量 + 0.7，估计标准误差 = 1.76）。在观察者内（平均差异0.64±0.52升/分钟）和观察者间（平均差异0.41±0.36升/分钟）研究（n = 8）中获得了可重复的多普勒心输出量测量结果。对于选定的患有心肺疾病的患者，在手术期间使用多普勒食管探头测量心输出量可用于血流动力学监测。
