Quaal S J
AACN Clin Issues Crit Care Nurs. 1993 Feb;4(1):197-206.
Patient care management decisions frequently are based, at least in part, on hemodynamic indices. Accuracy in repeated measurement of hemodynamic parameters is therefore critical. It can be achieved only through a program of quality assurance (QA), which should include the following factors: static, dynamic, and validation of pulmonary artery wedge pressure (PAWP). The static QA factor consists of establishing an accurate reference point from which all subsequent measurements are made. The hemodynamic monitoring system must be able to transmit pulsating physiologic pressures to the transducer with high fidelity, which is validated via the dynamic response or "square wave" test and damping coefficient. Other QA aspects that are used to validate the accuracy of PAWP include catheter placement into lung zone 3 capillary and comparison of capillary to arterial blood gases. Measurement error also can be introduced because of varying methods to quantify the ana-log pressure waveforms, such as end-expiratory or pressure averaging techniques. This paper explores each of these domains within a framework of quality assurance.
患者护理管理决策常常至少部分基于血流动力学指标。因此，血流动力学参数重复测量的准确性至关重要。这只能通过质量保证（QA）计划来实现，该计划应包括以下因素：静态、动态以及肺动脉楔压（PAWP）的验证。静态QA因素包括建立一个准确的参考点，后续所有测量都从此点进行。血流动力学监测系统必须能够将脉动的生理压力高保真地传输到换能器，这通过动态响应或“方波”测试以及阻尼系数来验证。用于验证PAWP准确性的其他QA方面包括将导管放置在肺区3的毛细血管中以及比较毛细血管血气与动脉血气。由于量化模拟压力波形的方法不同，例如呼气末或压力平均技术，也可能引入测量误差。本文在质量保证框架内探讨这些领域中的每一个。
