Delfino M, Carlone S, Angelici E, Zona C, Del Bolgia F, Nigri A, Serra P, Reale A
G Ital Cardiol. 1984 Feb;14(2):101-7.
When an alternating current of high frequency is applied to the thorax, the first derivative of the impedance (dZ/dt) is affected by the cardiac cycle, resulting in a characteristic wave form. The maximum negative of this wave occurring during systole together with the length of ejection time (VET), the blood resistivity, the basal impedance (ZO) and the distance between the inner detecting electrodes (L) makes it possible to calculate stroke volume (SV) and related parameters, as cardiac output (CO) and cardiac index (Cl) by a formula developed by Kubicek. Thoracic electrical impedance has been proposed as a non invasive technique to evaluate cardiac emodinamics. In the present study we have evaluated thoracic electrical impedance by comparing it with thermodilution, simultaneously performed in 21 catheterized patients. Reproducibility was assessed by comparing Cl measured several times in the same patient during ten minutes of rest in the supine position: coefficient of variation, expressed as CV = SD/m X 100 was 8,5 +/- 4,2% and 9,4 +/- 3,2% (p = NS) for thermodilution and thoracic electrical impedance respectively. Cl values obtained by both methods correlated well, with little scatter either baseline (r = 0,784, n = 40, p less than 0,001), either after an handgrip manoeuvre (r = 0,629, n = 15, p less than 0,05). This degree of correlation is similar to that observed comparing invasive techniques (Fick, thermodilution, dye dilution) either among them, or with noninvasive methods (echocardiography, gated equilibrium blood pool scintigraphy and ultrasonic Doppler).(ABSTRACT TRUNCATED AT 250 WORDS)
当高频交流电施加于胸部时,阻抗的一阶导数(dZ/dt)受心动周期影响,产生特征性波形。该波形在收缩期出现的最大负值,连同射血时间(VET)、血液电阻率、基础阻抗(ZO)以及内部检测电极之间的距离(L),使得通过Kubicek提出的公式计算每搏输出量(SV)及相关参数(如心输出量(CO)和心脏指数(Cl))成为可能。胸电阻抗已被提议作为一种评估心脏动力学的非侵入性技术。在本研究中,我们通过将其与热稀释法进行比较,对21例接受导管插入术的患者同时进行了胸电阻抗评估。通过比较同一患者在仰卧位休息十分钟期间多次测量的Cl来评估可重复性:热稀释法和胸电阻抗法的变异系数(CV = SD/m × 100)分别为8.5 ± 4.2%和9.4 ± 3.2%(p = 无显著性差异)。两种方法获得的Cl值相关性良好,无论是在基线时(r = 0.784,n = 40,p < 0.001)还是在进行握力动作后(r = 0.629,n = 15,p < 0.05),离散度都很小。这种相关程度与比较侵入性技术(Fick法、热稀释法、染料稀释法)之间或与非侵入性方法(超声心动图、门控平衡血池闪烁显像和超声多普勒)时观察到的相似。(摘要截短于250字)