危重症患者的心输出量测量：连续热稀释技术与传统热稀释技术的比较

Cardiac output measurement in critically ill patients: comparison of continuous and conventional thermodilution techniques.

作者信息

Lefrant J Y, Bruelle P, Ripart J, Ibanez F, Aya G, Peray P, Saïssi G, de La Coussaye J E, Eledjam J J

机构信息

Département d'Anesthésie-Réanimation et de l'Urgence, CHU Nîmes, France.

出版信息

Can J Anaesth. 1995 Nov;42(11):972-6. doi: 10.1007/BF03011067.

DOI:10.1007/BF03011067

PMID:8590506

Abstract

The purpose of the study was to compare cardiac output (CO) measurement by continuous (CTD) with that by conventional thermodilution (TD) in critically ill patients. In 19 of 20 critically ill patients requiring a pulmonary artery catheterism, 105 paired CO measurements were performed by both CTD and TD. Regression analysis showed that: CTD CO = 1.18 TD CO - 0.47. Correlation coefficient was 0.96. Bias and limit of agreement were -0.8 and 2.4 L.min-1, respectively. When a Bland and Altman diagram was constructed according to cardiac index ranges, biases were -0.2 and -0.3 and -0.8 L.min-1.m-2 and limits of agreement were 0.3, 0.7 and 1.6 L.min-1.m-2 for low (< 2.5 L.min-1.m-2), normal (between 2.5 and 4.5 L.min-1.m-2) and high (> 4.5 L.min-1.m-2) cardiac indexes, respectively. It is concluded that CTD, compared with TD, is a reliable method of measuring CO, especially when cardiac index is < or = 4.5 L.min-1.m-2.

摘要

本研究的目的是比较危重症患者中连续心排血量测定法（CTD）与传统热稀释法（TD）测量心排血量（CO）的情况。在20例需要放置肺动脉导管的危重症患者中，有19例通过CTD和TD进行了105组配对CO测量。回归分析显示：CTD测得的CO = 1.18×TD测得的CO - 0.47。相关系数为0.96。偏差和一致性界限分别为-0.8和2.4 L·min⁻¹。根据心脏指数范围绘制布兰德-奥特曼图时，低（< 2.5 L·min⁻¹·m⁻²）、正常（2.5至4.5 L·min⁻¹·m⁻²之间）和高（> 4.5 L·min⁻¹·m⁻²）心脏指数时的偏差分别为-0.2、-0.3和-0.8 L·min⁻¹·m⁻²，一致性界限分别为0.3、0.7和1.6 L·min⁻¹·m⁻²。得出的结论是，与TD相比，CTD是一种可靠的测量CO的方法，尤其是当心脏指数≤4.5 L·min⁻¹·m⁻²时。