Nikiforov Y V, Kisluchine V V, Chaus N I
Department of Intensive Care, National Research Center for Surgery, Moscow, Russia.
ASAIO J. 1996 Sep-Oct;42(5):M903-5. doi: 10.1097/00002480-199609000-00124.
Cardiac output was measured in 11 patients during extra-corporeal detoxification after open heart surgery. All patients were mechanically ventilated and had pulmonary artery catheters for cardiac output (COT) measured by thermodilution. A sensor on the arterial side of the extracorporeal circulation measured flow and sound velocity transients. Injections of 2-5 ml 0.9% saline at 37 degrees C into the arterial line upstream of the sensor permitted its calibration; 10-20 ml of the same solution was injected intravenously or into the venous dialysis injection port, and cardiac output (COUD) was calculated by the ultrasound velocity dilution technique. COT was measured within 5 min of the ultrasound dilution measurement. CO was in the range of 2-8 L/m. The regression equation was COUD = 1.09 x COT-0.32 (r = 0.97, n = 31). These data suggest agreement between the ultrasound dilution technique and thermodilution. Ultrasound dilution is preferable in patients undergoing extracorporeal detoxification when pulmonary artery catheterization is not required or dangerous.
在心脏直视手术后的体外解毒过程中,对11例患者进行了心输出量测量。所有患者均接受机械通气,并通过热稀释法使用肺动脉导管测量心输出量(COT)。体外循环动脉侧的一个传感器测量流量和声速瞬变。向传感器上游的动脉管路中注入2 - 5毫升37摄氏度的0.9%生理盐水以进行校准;将10 - 20毫升相同溶液静脉注射或注入静脉透析注射端口,然后通过超声速度稀释技术计算心输出量(COUD)。在超声稀释测量后5分钟内测量COT。CO范围为2 - 8升/分钟。回归方程为COUD = 1.09×COT - 0.32(r = 0.97,n = 31)。这些数据表明超声稀释技术与热稀释法结果一致。在不需要或进行肺动脉导管插入术有危险的体外解毒患者中,超声稀释法更可取。