Ohlsson A, Bennett T, Ottenhoff F, Bitkover C, Kjellström B, Nordlander R, Aström H, Rydén L
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
Eur Heart J. 1996 Dec;17(12):1902-10. doi: 10.1093/oxfordjournals.eurheartj.a014810.
Long-term monitoring of central haemodynamics with implanted monitoring systems might be valuable in managing heart failure patients. Such systems offer an opportunity for repeated 'semi-invasive' cardiac output determinations according to the Fick principle. Five patients, four with chronic heart failure and one with chronic pulmonary disease, underwent supine exercise testing during cardiac catheterization at 0, 2, 6 and 11 months after implantation of a right ventricular mixed venous oxygen saturation sensor connected to an implantable haemodynamic monitor. The monitor provided a continuous measure of oxygen saturation via a radio-telemetry link to a metabolic cart capable of measurement of breath-by-breath oxygen consumption. Cardiac output was computed using oxygen consumption, mixed venous oxygen saturation, arterial oxygen saturation by pulse oximetry and haemoglobin oxygen capacity. Biosensor-derived oxygen saturation compared to blood samples from the pulmonary artery showed an excellent correlation over time, r2 = 0.94 (implant), r2 = 0.91 (6-11 months). There was a strong correlation between semi-invasive-determined cardiac output using the biosensor and the invasive technique, which persisted over the entire follow-up period. Repeated semi-invasive cardiac output measurements using an implanted haemodynamic monitoring system in chronic heart failure patients is feasible and the data may be of value for optimizing therapy.
使用植入式监测系统对中心血流动力学进行长期监测可能对心力衰竭患者的管理具有重要价值。此类系统提供了根据菲克原理重复进行“半侵入性”心输出量测定的机会。五名患者，四名患有慢性心力衰竭，一名患有慢性肺部疾病，在植入与植入式血流动力学监测仪相连的右心室混合静脉血氧饱和度传感器后的0、2、6和11个月，于心脏导管插入术期间进行了仰卧位运动测试。该监测仪通过无线遥测链路与能够逐次呼吸测量耗氧量的代谢车相连，从而持续测量血氧饱和度。心输出量通过耗氧量、混合静脉血氧饱和度、脉搏血氧饱和度测定的动脉血氧饱和度以及血红蛋白氧容量来计算。与来自肺动脉的血样相比，生物传感器得出的血氧饱和度随时间显示出极佳的相关性，r2 = 0.94（植入时），r2 = 0.91（6 - 11个月）。使用生物传感器半侵入性测定的心输出量与侵入性技术之间存在很强的相关性，且在整个随访期内持续存在。在慢性心力衰竭患者中使用植入式血流动力学监测系统重复进行半侵入性心输出量测量是可行的，这些数据可能对优化治疗有价值。
