Pullman M D, Edwards N D
University Department of Anaesthetics, Northern General Hospital, Sheffield, UK.
Anaesthesia. 1997 Apr;52(4):367-73. doi: 10.1111/j.1365-2044.1997.az0083b.x.
A postal survey of 100 hospitals throughout the United Kingdom and Ireland was conducted to assess current practice in the pre-operative assessment and use of pulmonary artery catheters in patients undergoing elective abdominal aortic aneurysm repair. Seventy-four completed questionnaires were received. The survey revealed that 53% of respondents hold designated preoperative assessment clinics, attended by anaesthetists in 54% and cardiologists in 26%. However, only 4% of respondents have a written protocol for stratifying patients and assessing peri-operative risk. By far the commonest investigation of choice for further cardiological assessment is transthoracic echocardiography (67%). Other investigations of choice are multiple update gated acquisition (MUGA) scan (13%), dipyridamole thallium imaging (9%), exercise ECG (6%), stress echocardiography (1%) and stress MUGA (1%). Two units (3%) never undertook further investigation. Pulmonary artery flotation catheters are used as a routine by 9% of respondents, dependent upon left ventricular ejection fraction by 65%, dependent on other factors by 7% and not used at all by 19%. The survey reveals widespread variation in pre-operative assessment of patients undergoing elective repair of abdominal aortic aneurysm.
对英国和爱尔兰的100家医院进行了一项邮政调查，以评估择期腹主动脉瘤修复患者术前评估及肺动脉导管使用的当前实践情况。共收到74份完整问卷。调查显示，53%的受访者设有指定的术前评估门诊，其中54%由麻醉师出诊，26%由心脏病专家出诊。然而，只有4%的受访者有对患者进行分层和评估围手术期风险的书面方案。到目前为止，进一步心脏评估最常用的检查方法是经胸超声心动图（67%）。其他常用检查方法包括多重门控心脏血池显像（MUGA）扫描（13%）、双嘧达莫铊显像（9%）、运动心电图（6%）、负荷超声心动图（1%）和负荷MUGA（1%）。有两个单位（3%）从未进行过进一步检查。9%的受访者常规使用肺动脉漂浮导管，65%根据左心室射血分数决定是否使用，7%根据其他因素决定是否使用，19%根本不使用。该调查揭示了择期腹主动脉瘤修复患者术前评估存在广泛差异。
