Ng H W, Walleyl T J, Tsao Y, Fahal I H, Ahmad R, Breckenridge A M
Royal Liverpool University Hospital, Department of Pharmacology and Therapeutics, England.
Methods Find Exp Clin Pharmacol. 1995 Jan-Feb;17(1):59-65.
The reproducibility and reliability of cardiac output (CO) measurement by transthoracic electrical bioimpedance (TEB) and dual beam Doppler ultrasound methods were compared in 9 uremic patients during treatment with continuous ambulatory peritoneal dialysis (CAPD). CO was measured simultaneously by each method during supine rest and 70 degree passive head-up tilt on two separate days. The effect on CO after the infusion of dialysate was also studied on day 1. CO, stroke volume (SV) and heart rate (HR) measurements were reproducible by each method. The median day to day differences (95% confidence intervals) in CO and SV were 0.6 (-0.3, 1.8) l/min and 10 (-1.5, 24.5) ml for TEB and 0.7 (-0.5, 2.2) l/min and 13 (-1.0, 30.5) ml for Doppler at supine rest; 0.4 (-0.2, 0.9) l/min and 11 (-0.5, 19.0) ml for TEB and 0.5 (-0.3, 1.2) l/min and 8 (-5.0, 16.0) ml for Doppler during tilt (p > 0.05 in each case). Data were unobtainable by TEB at five time points while none were lost by Doppler. This is due to incorrect HR or poor quality signals detected by TEB. CO and SV measured by Doppler were higher than that by TEB during supine rest (p < or = 0.01) but not during passive tilt. As a result, there was significant change (p < or = 0.01) in CO and SV from supine to tilt measured by Doppler but not by TEB. Neither TEB nor Doppler detected significant change (p > 0.05) in CO or SV after the infusion of dialysate, in either the supine or tilt positions.(ABSTRACT TRUNCATED AT 250 WORDS)
在9例接受持续性非卧床腹膜透析(CAPD)治疗的尿毒症患者中,比较了经胸电阻抗(TEB)和双束多普勒超声法测量心输出量(CO)的可重复性和可靠性。在两个不同日期,分别于仰卧休息和被动头高位倾斜70度时,用每种方法同时测量CO。在第1天还研究了注入透析液后对CO的影响。每种方法测量的CO、每搏输出量(SV)和心率(HR)均可重复。仰卧休息时,TEB测量的CO和SV的日间中位数差异(95%置信区间)为0.6(-0.3,1.8)升/分钟和10(-1.5,24.5)毫升,多普勒测量的为0.7(-0.5,2.2)升/分钟和13(-1.0,30.5)毫升;倾斜时,TEB测量的为0.4(-0.2,0.9)升/分钟和11(-0.5,19.0)毫升,多普勒测量的为0.5(-0.3,1.2)升/分钟和8(-5.0,16.0)毫升(每种情况p>0.05)。TEB在五个时间点无法获得数据,而多普勒未丢失任何数据。这是由于TEB检测到的心率不正确或信号质量差。仰卧休息时,多普勒测量的CO和SV高于TEB测量的(p≤0.01),但在被动倾斜时并非如此。因此,多普勒测量的从仰卧到倾斜时CO和SV有显著变化(p≤0.01),而TEB未检测到。注入透析液后,无论在仰卧位还是倾斜位,TEB和多普勒均未检测到CO或SV有显著变化(p>0.05)。(摘要截短于250字)