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在重症监护病房患者中,经胸超声心动图与颈总动脉超声心动图测量心输出量的比较

Common Carotid Artery Sonography Versus Transthoracic Echocardiography for Cardiac Output Measurements in Intensive Care Unit Patients.

作者信息

Peng Qian-Yi, Zhang Li-Na, Ai Mei-Lin, Li Li, Hu Cheng-Huan, Zhang Yan-Xin, Liu Wei, Feng Qing, Zou Yu, Ai Yu-Hang

机构信息

Department of Critical Care Medicine, Central South University, Changsha, China.

Department of Anesthesia Xiang-ya Hospital, Central South University, Changsha, China.

出版信息

J Ultrasound Med. 2017 Sep;36(9):1793-1799. doi: 10.1002/jum.14214. Epub 2017 Apr 21.

DOI:10.1002/jum.14214
PMID:28429475
Abstract

OBJECTIVES

This study was designed to test the effectiveness of common carotid artery sonography in comparison with transthoracic echocardiography (TTE) for cardiac output measurements to provide an easier alternative for cardiac output monitoring in the intensive care unit.

METHODS

This study included 148 patients who had common carotid artery Doppler examinations and TTE performed within 8 hours of each other, and the cardiac output measurement results were compared with each other.

RESULTS

The mean age of the participants ± SD was 56.8 ± 16.2 years, with male patients composing 54.7% of the cohort. There was no significant difference in carotid and TTE cardiac output between different sexes, age groups, patients with and without mechanical ventilation, and primary indication groups. The overall intraclass correlation coefficient between the carotid and TTE cardiac output was 0.537. In patients with septic shock, multiple trauma, and respiratory failure, the intraclass correlation coefficients between TTE and carotid cardiac output were 0.241, 0.061, and 0.095, respectively.

CONCLUSIONS

Carotid cardiac output shows moderate agreement with TTE cardiac output; thus, its use may be considered as an alternative for estimating cardiac output in emergencies and when TTE cardiac output is unobtainable. However, in patients with septic shock, multiple trauma, and respiratory failure, the use of carotid cardiac output is not recommended.

摘要

目的

本研究旨在测试与经胸超声心动图(TTE)相比,颈总动脉超声检查在测量心输出量方面的有效性,以便为重症监护病房的心输出量监测提供一种更简便的替代方法。

方法

本研究纳入了148例患者,这些患者在彼此8小时内分别进行了颈总动脉多普勒检查和TTE检查,并将心输出量测量结果进行了相互比较。

结果

参与者的平均年龄±标准差为56.8±16.2岁,男性患者占队列的54.7%。不同性别、年龄组、有无机械通气的患者以及主要适应症组之间,颈动脉和TTE测量的心输出量无显著差异。颈动脉和TTE测量的心输出量之间的总体组内相关系数为0.537。在感染性休克、多发伤和呼吸衰竭患者中,TTE和颈动脉测量的心输出量之间的组内相关系数分别为0.241、0.061和0.095。

结论

颈动脉心输出量与TTE心输出量显示出中度一致性;因此,在紧急情况下以及无法获得TTE心输出量时,可考虑将其作为估计心输出量的替代方法。然而,对于感染性休克、多发伤和呼吸衰竭患者,不建议使用颈动脉心输出量。

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