Leone D, Servillo G, De Robertis E, Rossano F, Tufano R
Cattedra di Anestesia, Rianimazione e Terapia Intensiva, Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Napoli.
Minerva Anestesiol. 1998 Jul-Aug;64(7-8):351-6.
Evaluation of continuous cardiac output monitoring based on the esophageal Doppler in the critically ill.
Prospective clinical investigation.
An intensive care unit of an University hospital.
Ten critically ill patients who needed pulmonary artery catheterization.
Cardiac output was monitored continuously by a transesophageal Doppler device, consisting of an esophageal probe and a bedside microprocessor that calculated cardiac output using a new algorithm. Standard bolus thermodilution technique (10 ml of saline solution) was used to compare the continuous Doppler cardiac output measurement with the intermittent bolus measurement.
A total of 50 pairs of intermittent (bolus) cardiac output and continuous (Doppler) cardiac output measurements were obtained from the 10 patients. The mean value of CO measured with TD was 5.81 +/- 0.83, while using esophageal Doppler was 5.84 +/- 0.81. The correlation coefficient of the two methods was r = 0.93. The Bland and Altman showed 95% of agreement limits as +0.52 and -0.64 L/min.
Continuous monitoring of cardiac output using esophageal Doppler has proven to be safe, accurate, and precise when compared with the standard intermittent bolus thermodilution technique. The continuous monitoring technique improves our armamentarium for more intensive monitoring of the critically ill patients.
评估基于食管多普勒的连续心输出量监测在危重症患者中的应用。
前瞻性临床研究。
一所大学医院的重症监护病房。
10名需要进行肺动脉导管插入术的危重症患者。
使用经食管多普勒设备连续监测心输出量，该设备由一个食管探头和一个床边微处理器组成，微处理器使用一种新算法计算心输出量。采用标准团注热稀释技术（10毫升生理盐水）将连续多普勒心输出量测量结果与间歇性团注测量结果进行比较。
从10名患者中总共获得了50对间歇性（团注）心输出量和连续（多普勒）心输出量测量值。用热稀释法测得的心输出量平均值为5.81±0.83，而使用食管多普勒测得的值为5.84±0.81。两种方法的相关系数r = 0.93。布兰德-奥特曼分析显示95%的一致性界限为+0.52和-0.64升/分钟。
与标准间歇性团注热稀释技术相比，使用食管多普勒连续监测心输出量已被证明是安全、准确和精确的。这种连续监测技术改善了我们对危重症患者进行更强化监测的手段。
