Okamoto K, Komatsu T, Kumar V, Sanchala V, Kubal K, Bhalodia R, Shibutani K
Crit Care Med. 1986 Nov;14(11):977-80. doi: 10.1097/00003246-198611000-00014.
Sequential thermodilution measurements of cardiac output in mechanically ventilated patients undergoing cardiac surgery demonstrated a cyclic modulation which correlated with changes in airway pressure, and was not affected by opening the pericardium. There was no satisfactory point for single measurements, which suggests that random thermodilution measurements of cardiac output during intermittent positive-pressure ventilation should be avoided, even when triplicate measurements are performed. To estimate the mean cardiac output, at least two measurements should be made at predetermined points of the ventilatory cycle. We recommend paired measurements at midinspiration and end-expiration.
对接受心脏手术的机械通气患者进行的心输出量连续热稀释测量显示出一种周期性调节，这种调节与气道压力变化相关，且不受心包打开的影响。单次测量没有令人满意的结果，这表明即使进行三次重复测量，也应避免在间歇正压通气期间对心输出量进行随机热稀释测量。为了估计平均心输出量，应在通气周期的预定点至少进行两次测量。我们建议在吸气中期和呼气末期进行配对测量。
