Hodges M, Downs J B, Mitchell L A
Crit Care Med. 1975 Sep-Oct;3(5):182-4. doi: 10.1097/00003246-197509000-00002.
With the thermodilution technique, repeated determination of cardiac index (CI) has become a rapid, easily accomplished, safe procedure. We paired 77 CI determinations measured by direct Fick and thermodilution techniques in 21 patients who underwent myocardial revascularization. Commercially available thermistor-tipped catheters and a cardiac output computer were used to determine CI according to the manufacturer's instructions. Oxygen consumption and arterial-venous oxygen content differences were measured directly to determine CI by the Fick method. Comparisons were made during mechanical ventilation with and without positive end-expiratory pressure (PEEP) and during spontaneous ventilation with and without PEEP. Cardiac indices measured by the two techniques were within +/- 0.5 L/min/m2 of each other only 76% of the time and within +/- 1.0 L/min/m2 96% of the time, if CI greater than or equal to 4.0 L/min/m2 were omitted. Ventilatory pattern had no apparent effect on results.
采用热稀释技术，重复测定心脏指数（CI）已成为一种快速、易于完成且安全的操作。我们对21例行心肌血运重建术患者的77次通过直接Fick法和热稀释技术测定的心脏指数进行了配对。根据制造商的说明，使用市售的热敏电阻尖端导管和心输出量计算机来测定心脏指数。通过直接测量耗氧量和动静脉氧含量差，用Fick法测定心脏指数。在有和没有呼气末正压（PEEP）的机械通气期间以及有和没有PEEP的自主通气期间进行比较。如果排除心脏指数大于或等于4.0L/min/m²的情况，两种技术测定的心脏指数仅在76%的时间内彼此相差±0.5L/min/m²，在96%的时间内相差±1.0L/min/m²。通气模式对结果无明显影响。
