Johnson M K, Schumann L
Deaconess Medical Center, Spokane, Wash., USA.
Am J Crit Care. 1995 Jul;4(4):300-7.
Pulmonary artery catheter readings are critical for clinical decision making and therapeutic intervention in critically ill patients. Research data of digital display versus graphic strip chart recording of hemodynamic pressures during spontaneous breathing and mechanical ventilation are inconclusive.
To compare three methods of measurement of hemodynamic pressure readings from the pulmonary artery catheter in critically ill patients during mechanical ventilation and spontaneous breathing.
A nonrandomized, repeated-measures design was used to compare hemodynamic pressures (right atrial, systolic, diastolic, and wedge pressures) from the pulmonary artery catheter in cardiovascular patients during mechanical ventilation (n = 25) and again during spontaneous breathing (n = 19).
Using repeated measures analysis of variance, statistically significant differences were noted in the pulmonary artery diastolic, wedge, and right atrial pressure during mechanical ventilation. During spontaneous breathing, significant differences occurred in pulmonary artery systolic and wedge pressures only. No statistically significant difference occurred in the systolic pressure during mechanical ventilation, or the pulmonary artery diastolic and right atrial pressures during spontaneous breathing.
The results of this study indicate that graphic recording is the most reliable means of measuring hemodynamic pressure at end-expiration. Further research is needed to validate these findings with other models of monitoring equipment and other patient populations.
肺动脉导管读数对于危重症患者的临床决策和治疗干预至关重要。关于在自主呼吸和机械通气期间血流动力学压力的数字显示与图表记录的研究数据尚无定论。
比较危重症患者在机械通气和自主呼吸期间通过肺动脉导管测量血流动力学压力读数的三种方法。
采用非随机重复测量设计，比较心血管疾病患者在机械通气（n = 25）和自主呼吸（n = 19）期间通过肺动脉导管测得的血流动力学压力（右心房压、收缩压、舒张压和楔压）。
使用重复测量方差分析，在机械通气期间肺动脉舒张压、楔压和右心房压存在统计学显著差异。在自主呼吸期间，仅肺动脉收缩压和楔压出现显著差异。在机械通气期间收缩压，或在自主呼吸期间肺动脉舒张压和右心房压均未出现统计学显著差异。
本研究结果表明，图表记录是测量呼气末血流动力学压力的最可靠方法。需要进一步研究以用其他监测设备模型和其他患者群体验证这些发现。
