Jardin F, Gueret P, Dubourg O, Farcot J C, Margairaz A, Bourdarias J P
Chest. 1985 Jul;88(1):34-9. doi: 10.1378/chest.88.1.34.
Measurements of right ventricular ejection fraction and volumes were obtained at bedside by the thermodilution method performed with a fast-response balloon-tipped thermistor in a group of 18 patients undergoing respiratory therapy for the adult respiratory distress syndrome (ARDS). These measurements were compared with right ventricular dimensions simultaneously obtained with two-dimensional echocardiography. A significant correlation was found between right ventricular ejection fraction by thermodilution and two-dimensional echocardiographic fractional area contraction (r = 0.74; p less than 0.001), between right ventricular end-diastolic volume by thermodilution and two-dimensional echocardiographic end-diastolic area (r = 0.70; p less than 0.001), and between right ventricular end-systolic volume by thermodilution and two-dimensional echocardiographic end-systolic area (r = 0.78; p less than 0.001). Right ventricular end-diastolic pressure, a commonly used index of right ventricular preload, did not correlate with two-dimensional echocardiographic end-diastolic area. In conclusion, the thermodilution method allowed reliable measurements of right ventricular ejection fraction and volumes at bedside in critically ill patients. Appraisal of right ventricular end-diastolic volume by this method appeared to be a better predictor of right ventricular preload than were the measurements of pressure.
在一组18例接受成人呼吸窘迫综合征（ARDS）呼吸治疗的患者中，采用快速响应球囊尖端热敏电阻通过热稀释法在床边测量右心室射血分数和容积。将这些测量结果与同时用二维超声心动图获得的右心室尺寸进行比较。发现热稀释法测得的右心室射血分数与二维超声心动图测得的面积分数缩短之间存在显著相关性（r = 0.74；p < 0.001），热稀释法测得的右心室舒张末期容积与二维超声心动图测得的舒张末期面积之间存在显著相关性（r = 0.70；p < 0.001），热稀释法测得的右心室收缩末期容积与二维超声心动图测得的收缩末期面积之间存在显著相关性（r = 0.78；p < 0.001）。右心室舒张末期压力，一种常用的右心室前负荷指标，与二维超声心动图舒张末期面积不相关。总之，热稀释法能够在床边对危重症患者的右心室射血分数和容积进行可靠测量。通过该方法评估右心室舒张末期容积似乎比压力测量更能准确预测右心室前负荷。
