心脏输出量和循环血容量的脉冲染料密度分析。

T Iijima, T Aoyagi, Y Iwao, J Masuda, M Fuse, N Kobayashi, H Sankawa
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引用次数: 139

摘要

目的:脉冲染料密度测定法(PDD)是一种监测动脉内吲哚菁绿(ICG)浓度的新方法,可以测定心输出量(CO)和循环血容量(CBV)。我们评估了其临床应用的准确性。方法:对7例全麻患者,采用805 nm和890 nm的icg敏感光学探针连接手指。注射ICG后,用无创检测仪光学记录动脉中染料浓度,并分光光度法测定动脉血中ICG浓度进行比较。为了验证PDD分析,我们还对8例计划行冠状动脉旁路移植术的患者采用染料稀释比色皿法和热稀释法测量了CO。在另外30例患者中,将PDD评估的CBV值与从体型估计的CBV值进行比较。结果:血中染料浓度与PDD值相关性良好(r = 0.953, p < 0.01)。与试管法相比,PDD CO测试的平均偏差为+0.15 +/- 0.72 min -1(无统计学意义),而热稀释法与试管法的平均偏差为+0.79 +/- 0.84 min -1 (p < 0.0001.)。PDD测得的CBV平均值为3.81 +/- 1.39 L,而估计值为3.72 +/- 0.77 L (n.s)。结论:PDD法测定的CO值与比色皿密度法测定的结果吻合较好,而与热稀释法测定的CO值较差。新方法不需要肺动脉导管,比旧方法侵入性更小,而且还能获得CBV值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiac output and circulating blood volume analysis by pulse dye-densitometry.

Objective: Pulse dye-densitometry (PDD) is a newly developed method for monitoring the indocyanine green (ICG) concentration in an artery with which cardiac output (CO) and circulating blood volume (CBV) can be determined. We evaluated its accuracy for clinical use.

Methods: In 7 patients under general anesthesia, ICG-sensitive optical probes (805 and 890 nm) were attached to a finger. Following injection of ICG, the arterial concentration of dye was recorded optically by the non-invasive test instrument and sampled arterial blood ICG concentration was also measured photometrically for comparison. In order to validate the PDD analysis, CO was also measured by both the dye dilution cuvette method and by thermodilution in 8 patients scheduled for coronary artery bypass grafting. In 30 other patients, CBV assessed by PDD was compared with its value estimated from body size.

Results: The blood dye concentration correlated well with the values obtained by PDD (r = 0.953, p < 0.01). Mean bias for the test PDD CO was +0.15 +/- 0.72 min l-1 (not significant (n.s.)) compared with the cuvette method while the mean bias of the thermodilution method vs the cuvette method was +0.79 +/- 0.84 min l-1 (p < 0.0001.). The average value of CBV obtained by PDD was 3.81 +/- 1.39 L compared with that estimated value, 3.72 +/- 0.77 L (n.s.).

Conclusions: CO determined by PDD agrees well with cuvette densitometry, and somewhat less well with CO by thermodilution. The new method, by not requiring a pulmonary arterial catheter, is less invasive than either older method, and yields in addition a value of CBV.

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