Netz H, Schanné U, Pabst W, Rautenburg H W
Z Kardiol. 1987 Jan;76(1):51-7.
Oxygen consumption (VO2) must be known to calculate the hemodynamic parameters by Fick's principle. Often VO2 is not measured directly but calculated by nomograms. An open-system method was used for measuring oxygen consumption continuously in 140 healthy infants and children and 152 with congenital heart disease. The patients with heart disease were divided in three groups: I - with large left-to-right shunt (more than 40%), II - with a small left-to-right shunt, and III - without left-to-right shunt. In group I a significantly higher oxygen consumption was measured. There was also a difference in relation of indexed oxygen consumption to age between group I and all the other children. In a second part we compared two methods for determination of indexed oxygen consumption (VO2) in infants and children: measurement using an open system method estimation by using formulas. In healthy infants estimation showed higher values; but no difference was found in healthy children or those without significant left-to-right shunt. In children with congenital heart disease and large left-to-right shunt measured VO2 was significantly higher than the estimated values. No correlation was found in infants with large left-to-right shunt. But in these cases the exact calculation of the hemodynamic parameters would be of great importance. The results indicate that measurement rather than estimation of VO2 is necessary for calculation of hemodynamic parameters.
为通过菲克原理计算血流动力学参数,必须先了解耗氧量(VO₂)。通常VO₂并非直接测量,而是通过列线图计算得出。采用开放系统法对140名健康婴幼儿及152名先天性心脏病患儿进行连续耗氧量测量。患有心脏病的患儿被分为三组:I组——左向右分流较大(超过40%);II组——左向右分流较小;III组——无左向右分流。在I组中测得的耗氧量明显更高。I组与其他所有儿童相比,每平方米体表面积耗氧量与年龄的关系也存在差异。在第二部分中,我们比较了两种测定婴幼儿每平方米体表面积耗氧量(VO₂)的方法:使用开放系统法测量和使用公式估算。在健康婴幼儿中,估算值较高;但在健康儿童或无明显左向右分流的儿童中未发现差异。在患有先天性心脏病且左向右分流较大的儿童中,测得的VO₂明显高于估算值。在左向右分流较大的婴幼儿中未发现相关性。但在这些情况下,血流动力学参数的精确计算至关重要。结果表明,为计算血流动力学参数,测量VO₂而非估算VO₂是必要的。