Babu S C, Sharma P V, Raciti A, Mayr C H, Elrabie N A, Clauss R H, Stahl W M, Del Guercio L R
Arch Surg. 1980 Nov;115(11):1384-6. doi: 10.1001/archsurg.1980.01380110116018.
Poor cardiopulmonary reserve was demonstrated in a group of 75 elderly patients undergoing elective vascular reconstruction when cardiovascular hemodynamics were analyzed with the automated physiologic profile (APP) preoperatively. Only 25 patients (33.3%) had normal left ventricular function (LVF) and did not need any corrective therapy before surgery. Increment in preload was necessary in 20 patients (26.7%) to improve myocardial function; 30 patients (40%) revealed abnormal LVF and hence required pharmacologic modulation and preload adjustment, inotropic support, and afterload reduction to enhance the ventricular performance. Conventional methods of clinical evaluation did not reveal the degree of compromised ventricular function and potential high risk of surgical morbidity and mortality in many of these patients. The APP disclosed subtle and important physiologic aberrations indicating modification of anesthetic and operative procedures and precise modulation of physiologic factors. Optimization was achieved in all except two patients, and only one was denied the benefits of vascular reconstruction.
术前采用自动生理分析系统（APP）对75例接受择期血管重建手术的老年患者进行心血管血流动力学分析时，发现这些患者存在心肺储备功能差的情况。只有25例患者（33.3%）左心室功能（LVF）正常，术前无需任何纠正治疗。20例患者（26.7%）需要增加前负荷以改善心肌功能；30例患者（40%）左心室功能异常，因此需要进行药物调节、前负荷调整、正性肌力支持和降低后负荷，以增强心室功能。传统的临床评估方法并未揭示许多此类患者心室功能受损的程度以及手术发病率和死亡率的潜在高风险。APP揭示了细微而重要的生理异常，提示需修改麻醉和手术操作，并精确调节生理因素。除两名患者外，所有患者均实现了优化，只有一名患者未能从血管重建中获益。
