肺移植术后热稀释法与预估菲克心输出量测量的预测价值
Post lung-transplant predictive value of thermodilution vs estimated Fick cardiac output measurement.
作者信息
Rivera-Robles Jose, Alam Komal, Abdelmonem Ahmed, Edwards Audrene, Abdelreheim Ahmad, Mathai Susan K, Duncan Michael, Naik Chetan
机构信息
Baylor University Medical Center, Dallas, Texas.
Texas A&M University, College of Medicine, Bryan, Texas.
出版信息
JHLT Open. 2025 Feb 14;8:100228. doi: 10.1016/j.jhlto.2025.100228. eCollection 2025 May.
BACKGROUND
Comparison of thermodilution (TD) and indirect Fick (iFick) methods of cardiac output (CO) measurement has not been well described in patients with World Health Organization (WHO) group 3 pulmonary hypertension (PH).
METHODS
We conducted a single-center retrospective chart review of 96 patients with WHO group 3 PH who underwent lung transplantation. For comparison, 32 WHO group 1 pulmonary arterial hypertension patients who were followed in our PH clinic during the same period were also included in the study.
RESULTS
TThere was a significant difference between iFick CO and TD CO (5.93+/ -1.5 versus 5.46+/ -1.8 liter/minute, =0.0061) in WHO group 3 PH. Pulmonary vascular resistance (PVR) calculated using iFick and TD-CO values also differed significantly. TD-PVR was more strongly associated with measures of poor outcomes after lung transplant.
CONCLUSIONS
iFick-CO and TD-CO can be significantly different in WHO group 3 PH. In cases of discrepancy between iFick and TD-COs, TD-CO correlates better with clinical outcomes after lung transplantation.
背景
在世界卫生组织（WHO）3组肺动脉高压（PH）患者中，心输出量（CO）测量的热稀释法（TD）和间接菲克法（iFick）的比较尚未得到充分描述。
方法
我们对96例接受肺移植的WHO 3组PH患者进行了单中心回顾性病历审查。为了进行比较，同期在我们的PH诊所随访的32例WHO 1组肺动脉高压患者也纳入了研究。
结果
在WHO 3组PH中，iFick法测得的CO与TD法测得的CO之间存在显著差异（5.93±1.5对5.46±1.8升/分钟，P = 0.0061）。使用iFick和TD-CO值计算的肺血管阻力（PVR）也有显著差异。TD-PVR与肺移植后不良结局的指标相关性更强。
结论
在WHO 3组PH中，iFick-CO和TD-CO可能存在显著差异。在iFick和TD-CO结果不一致的情况下，TD-CO与肺移植后的临床结局相关性更好。
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