Heringlake Matthias, Kouz Karim, Saugel Bernd
Department of Anesthesiology and Intensive Care Medicine, Heart- and Diabetes Center Mecklenburg - Western Pomerania, Karlsburg Hospital, Karlsburg, Germany.
Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
Br J Anaesth. 2023 Dec;131(6):971-974. doi: 10.1016/j.bja.2023.08.017. Epub 2023 Sep 14.
Flow-directed, balloon-tipped pulmonary artery catheters allow measuring cardiac output and other haemodynamic variables including intracardiac pressures. We propose classifying pulmonary artery catheters by generations and specifying additional measurement modalities. Based on the method used to measure cardiac output, pulmonary artery catheters can be classified into three generations: first-generation using intermittent pulmonary artery thermodilution; second-generation using a thermal filament for automated pulmonary artery thermodilution; and third-generation combining thermal filament-based automated pulmonary artery thermodilution and pulmonary artery pulse wave analysis. Each of these pulmonary artery catheter generations can include additional measurements, such as continuous mixed venous oxygen saturation, right ventricular ejection fraction and end-diastolic volume, and right ventricular pressure. This classification should help define indications for pulmonary artery catheters in clinical practice and research.
血流导向的、带球囊尖端的肺动脉导管可用于测量心输出量和其他血流动力学变量,包括心内压力。我们建议按代对肺动脉导管进行分类,并明确其他测量方式。根据测量心输出量的方法,肺动脉导管可分为三代:第一代采用间歇性肺动脉热稀释法;第二代采用热丝进行自动肺动脉热稀释;第三代结合基于热丝的自动肺动脉热稀释和肺动脉脉搏波分析。这些代的肺动脉导管每一代都可包括其他测量项目,如连续混合静脉血氧饱和度、右心室射血分数和舒张末期容积,以及右心室压力。这种分类应有助于在临床实践和研究中明确肺动脉导管的适应证。