Isogai Hatsuo, Ogasawara Osamu
Emergency and Critical Care Medicine, Kariya Toyota General Hospital, Kariya, JPN.
Cureus. 2022 Jul 25;14(7):e27257. doi: 10.7759/cureus.27257. eCollection 2022 Jul.
Introduction Left ventricular outflow tract velocity time integral (LVOT VTI) is a promising surrogate for stroke volume (SV). However, there is controversy in the literature regarding its correlation with thermodilution or newer cardiac output measurement techniques. This study was conducted to determine the correlation between LVOT VTI determined by transesophageal echocardiography (TEE) with stroke volume index (SVI) calculated by thermodilution. Methods Consecutive patients older than 17 years undergoing elective cardiac surgery with pulmonary artery catheter (PAC) and TEE monitoring between September 2021 and February 2022 were included in this prospective, descriptive, single-center study. LVOT VTI was measured using TEE after induction of anesthesia but before skin incision and at least four hours after initial LVOT VTI measurement. SVI was simultaneously measured using the continuous thermodilution technique with a PAC. The correlation between LVOT VTI and SVI was determined with Pearson's correlation index. Results Twelve patients were included and 21 paired measurements were compared. Mean SVI was 31.62 ± 10.71 mL/m and mean LVOT VTI was 14.74 ± 4.79 cm. The Pearson's correlation index for the two measurements was r = 0.257, p = 0.262. Conclusion This prospective study demonstrated a weak correlation between LVOT VTI and SVI in patients undergoing cardiac surgery.
引言 左心室流出道速度时间积分(LVOT VTI)是每搏输出量(SV)一个很有前景的替代指标。然而,关于其与热稀释法或更新的心输出量测量技术之间的相关性,文献中存在争议。本研究旨在确定经食管超声心动图(TEE)测定的LVOT VTI与热稀释法计算的每搏输出量指数(SVI)之间的相关性。方法 本前瞻性、描述性、单中心研究纳入了2021年9月至2022年2月期间连续接受择期心脏手术且接受肺动脉导管(PAC)和TEE监测的17岁以上患者。在麻醉诱导后但皮肤切开前以及首次测量LVOT VTI至少4小时后,使用TEE测量LVOT VTI。使用PAC通过连续热稀释技术同时测量SVI。用Pearson相关指数确定LVOT VTI与SVI之间的相关性。结果 纳入12例患者,比较了21对测量值。平均SVI为31.62±10.71 mL/m,平均LVOT VTI为14.74±4.79 cm。两次测量的Pearson相关指数为r = 0.257,p = 0.262。结论 这项前瞻性研究表明,心脏手术患者中LVOT VTI与SVI之间存在弱相关性。