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电心排量监测与经胸超声心动图在小儿心脏手术后患者中的非侵入性心排量监测比较 - 一项前瞻性观察研究。

Comparison of noninvasive cardiac output monitoring by electrical cardiometry with transthoracic echocardiography in postoperative paediatric cardiac surgical patients - A prospective observational study.

机构信息

Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India.

出版信息

Ann Card Anaesth. 2023 Oct-Dec;26(4):380-385. doi: 10.4103/aca.aca_9_23.

DOI:10.4103/aca.aca_9_23
PMID:37861570
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10691584/
Abstract

AIM

The present study was conducted to validate cardiac output (CO) and cardiac index (CI) obtained from electrical cardiometry (EC) ICON with transthoracic echocardiography (TTE) in postoperative pediatric cardiac surgical patients.

MATERIALS AND METHODS

A prospective observational study was conducted in 25 pediatric patients with age < 10 years who underwent elective cardiac surgery.

DATA ANALYSIS

BlandAltman plot was constructed for interchangeability and Polar plot was constructed to know trending ability.

RESULTS

A total of 250 datasets were analyzed. Spearman's correlation coefficient for CO between ICON and TTE showed good positive correlation (r = 0.850, 95% confidence interval 0.81 to 0.881, P <.0001). Moderate positive correlation was observed between ICON and TTE for CI (r = 0.60, 95% confidence interval 0.515 to 0.674, P <.0001). Linear regression equations for CO and CI between ICON and TTE were: y = 0.5230 + 0.8078 X (R = 0.6597, P <.001) and y = 1.8350 + 0.5869 X (R = 0.3985, P <.001) [y- ICON ; X - TTE], respectively. BlandAltman plot for CO between ICON and TTE showed a bias of 0.3012 with limits of agreement (LOA) being -0.69 to 1.3 and for CI bias was 0.6939 with LOA-2.1 to 3.5. Polar plot analysis showed an angular bias of 8.1750, with radial LOA being -13.74° to 30.08° for CO and angular bias of 6.6931, with radial LOA being -15.69° to 29.07° for CI.

CONCLUSION

ICON monitor-derived parameters are not interchangeable with the values derived from TTE. However, the ICON monitor demonstrated a good trending ability for both CO and CI.

摘要

目的

本研究旨在验证经胸超声心动图（TTE）与心电机械图（EC） ICON 在小儿心脏手术后患者中测量心输出量（CO）和心指数（CI）的准确性。

材料与方法

本前瞻性观察研究纳入了 25 名年龄<10 岁的择期心脏手术患儿。

数据分析

采用 Bland-Altman 图进行可互换性分析，采用极坐标图分析趋势能力。

结果

共分析了 250 组数据集。ICON 与 TTE 测量 CO 的 Spearman 相关系数显示出良好的正相关性（r = 0.850，95%置信区间为 0.81 至 0.881，P<.0001）。ICON 与 TTE 测量 CI 时，中度正相关（r = 0.60，95%置信区间为 0.515 至 0.674，P<.0001）。ICON 与 TTE 测量 CO 和 CI 的线性回归方程分别为：y = 0.5230 + 0.8078 X（R = 0.6597，P<.001）和 y = 1.8350 + 0.5869 X（R = 0.3985，P<.001）[y- ICON ；X - TTE]。ICON 与 TTE 测量 CO 的 Bland-Altman 图显示出 0.3012 的偏倚，一致性界限（LOA）为-0.69 至 1.3，CI 的偏倚为 0.6939，LOA 为-2.1 至 3.5。极坐标图分析显示 CO 的角度偏倚为 8.1750，径向 LOA 为-13.74°至 30.08°，CI 的角度偏倚为 6.6931，径向 LOA 为-15.69°至 29.07°。

结论

ICON 监测仪衍生参数与 TTE 衍生值不可互换。然而，ICON 监测仪在 CO 和 CI 方面均显示出良好的趋势能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/24b635a49637/ACA-26-380-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/022474fb3818/ACA-26-380-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/3197146b2fc4/ACA-26-380-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/5aa25289c94c/ACA-26-380-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/54621fee29de/ACA-26-380-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/24b635a49637/ACA-26-380-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/022474fb3818/ACA-26-380-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/3197146b2fc4/ACA-26-380-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/5aa25289c94c/ACA-26-380-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/54621fee29de/ACA-26-380-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b997/10691584/24b635a49637/ACA-26-380-g005.jpg

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本文引用的文献

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Electrical Cardiometry to Monitor Cardiac Output in Preterm Infants with Patent Ductus Arteriosus: A Comparison with Echocardiography.心电心输出量测定法监测动脉导管未闭早产儿的心输出量：与超声心动图的比较
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Low-Cardiac-Output Syndrome After Cardiac Surgery.
心脏手术后的低心排血量综合征
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Non-invasive measurement of cardiac output in obese children and adolescents: comparison of electrical cardiometry and transthoracic Doppler echocardiography.肥胖儿童和青少年心输出量的无创测量：心电测量和经胸多普勒超声心动图的比较。
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