Kohanna F H, Cunningham J N
J Thorac Cardiovasc Surg. 1977 Mar;73(3):451-7.
One hundred twenty-five separate cardiac output determinations were obtained after open-heart surgery in 10 patients by simultaneous use of thermodilution and dye-dilution techniques. Mean thermodilution cardiac output was 1.6 per cent greater than mean dye-dilution cardiac output (5.24 versus 5.16 L. per minute). Reproducibility of thermodilution cardiac output (coefficient of variation, 8.6 per cent) was superior to that of dye-dilution cardiac output (coefficient of variation, 12.3 per cent) for outputs ranging from 2.5 to 8.7 L. per minute (p less than 0.001). Linear regression analysis revealed a correlation showing that COtd = 0.86 COdye + 0.80 (r = 0.9, p less than 0.001) and indicating a similarity between thermodilution and dye-dilution output figures except in extremely low output states. In such cases, thermodilution cardiac output becomes progressively larger than dye-dilution cardiac output. The results indicate that thermodilution cardiac output is a valid method for determining cardiac output in the rapidly changing clinical setting following cardiopulmonary bypass. Clinical applications of this technique include evaluation of the efficacy of inotropic agents, effectiveness of intra-aortic balloon counterpulsation, and status of the low output syndrome postoperatively. Routine use in patients with Class III or IV cardiac disease appears justified.
通过同时使用热稀释法和染料稀释法，对10例患者进行了心脏直视手术后的125次独立心输出量测定。热稀释法测定的平均心输出量比染料稀释法测定的平均心输出量高1.6%（分别为每分钟5.24升和5.16升）。对于每分钟2.5至8.7升的心输出量范围，热稀释法心输出量的可重复性（变异系数为8.6%）优于染料稀释法心输出量（变异系数为12.3%）（p<0.001）。线性回归分析显示两者具有相关性，即COtd = 0.86 COdye + 0.80（r = 0.9，p<0.001），这表明除了在极低心输出量状态下，热稀释法和染料稀释法的心输出量数值相似。在这种情况下，热稀释法测定的心输出量会逐渐大于染料稀释法测定的心输出量。结果表明，在体外循环后快速变化的临床环境中，热稀释法心输出量是测定心输出量的有效方法。该技术的临床应用包括评估正性肌力药物的疗效、主动脉内球囊反搏的效果以及术后低心输出量综合征的状况。对于III级或IV级心脏病患者，常规使用该方法似乎是合理的。
