Bizouarn P, Blanloeil Y, Pinaud M
Service d'Anesthésie-Réanimation, Hôpital G. et R. Laennec, Nantes.
Ann Fr Anesth Reanim. 1994;13(5):685-9. doi: 10.1016/s0750-7658(05)80725-7.
Recently, a thermodilution technique for continuous measurement of cardiac output was introduced. The aim of this study was to evaluate the accuracy of continuous cardiac output measurement using the thermodilution technique (CCO) and to assess the correspondence between CCO and cardiac output obtained with the Fick's principle (Fick-CO). Nine patients were studied in the postoperative period after cardiac surgery. A new pulmonary artery catheter modified by attachment of a thermal filament (Intellicath, Model PA3-H-8Fr) was inserted and connected to a continuous cardiac output computer (Vigilance Monitor). Oxygen consumption was continuously measured using the gas exchange method (Deltatrac Metabolic Monitor). Fick-CO was calculated according to the Fick's principle. The study in each patient consisted of 6 serial determinations of both CCO and Fick-CO at 10 min intervals. For 54 pairs of measurements, the mean difference (Fick-CO-CCO) was 0,6 L.min-1. The limits of agreement were--0,6 to 1,8 L.min-1 respectively. The relative error was 6% for CCO and 10% for Fick-CO. It is concluded that CCO and Fick-CO cannot be considered as being interchangeable. However, the accuracy of CCO is acceptable. The technique does not require any user calibration and eliminates the need of bolus injections. Further studies are necessary to determine the benefits of this new technique in the various clinical situations.
最近,一种用于连续测量心输出量的热稀释技术被引入。本研究的目的是评估使用热稀释技术连续测量心输出量(CCO)的准确性,并评估CCO与通过菲克原理获得的心输出量(菲克-CO)之间的一致性。对9例心脏手术后的患者进行了研究。插入一根通过连接热丝进行改良的新型肺动脉导管(Intellicath,型号PA3-H-8Fr),并将其连接到连续心输出量计算机(Vigilance监护仪)上。使用气体交换法(Deltatrac代谢监护仪)连续测量氧耗量。根据菲克原理计算菲克-CO。对每位患者的研究包括以10分钟为间隔对CCO和菲克-CO进行6次连续测定。对于54对测量值,平均差值(菲克-CO - CCO)为0.6L·min⁻¹。一致性界限分别为-0.6至1.8L·min⁻¹。CCO的相对误差为6%,菲克-CO的相对误差为10%。得出的结论是,不能认为CCO和菲克-CO是可互换的。然而,CCO的准确性是可以接受的。该技术不需要任何用户校准,并且无需进行团注注射。有必要进行进一步的研究以确定这种新技术在各种临床情况下的益处。