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首页> 外文会议>World congress on medical physics and biomedical engineering;International congress of the IUPESM >Lack of reliability of cardiac output measurements derived from arterial pressure waveform analysis in on-pump cardiac surgery patients
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Lack of reliability of cardiac output measurements derived from arterial pressure waveform analysis in on-pump cardiac surgery patients

机译：泵上心脏手术患者的动脉压波形分析得出的心输出量测量结果缺乏可靠性

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The arterial pressure waveform-based device for cardiac output (CO) measurement FloTrac/Vigileo~(TM) offers the possibility of minimal-invasive CO monitoring without the need for invasive calibration. The agreement of the results of this device with bolus thermodilution remains controversialS is the choice of the best arteriattannulation siteAfter approval of the local ethics committee 14 Patients scheduled for elective cardiac surgery with cardiopulmonary bypass were enrolled. Routine arterial access inone radial and one femoral artery were used for CO measurement with the FloTrac/Vigileo device Pulmonary artery catheter was inserted for determination of CO with thermodilution bolus technique. All CO was indexed to body surface area resulting in CI_FEM, CI_RAD and CI_PAC. Measurements were performed at least four times before and three times after CPB.A total of 262 data pais were analysed. Including all data before and after CPB bias and precision for CI PAC vs. CI_FEM were 0,09 L min~(-1)m~(-2) and ±1,01 Lmin~(-1)m~(-2), with a percentage error of 40%. For CI_PAC vs. CI_RADbias and precision were 034 Lmin~(-1)m~(-2)and ±1,08 Lmin~(-1)m~(-2) with a percentage error of 45%. CI_FEMvs. CI_RAD revealed a bias of-0,25 Lmin~(-1)m~(-2) and a precision of ±0,48 Lmin~(-1)m~(-2)resulting in a percentage error of 20%. Subgroup analysis of data pairs obtained before CPB showed a percentage error of 32% and 34% for CI_PAC vs. CI_FEM and CI_PAC vs. CI_RAD respectively. After CPB percentage error was 46% for CI_PAC vs. CI_FEM and 55% for CI_PAC vs. CI_RAD.We conclude that the agreement between CO measured with the FloTrac/Vigileo™ device and the thermodilution bolus method is not sufficient for clinical diagnosis and therapy guidance in the setting of cardiac anesthesia with CPB.
机译：用于测量心输出量（CO）的基于动脉压力波形的设备FloTrac / Vigileo〜（TM）提供了微创CO监测的可能性，而无需进行侵入性校准。该装置的结果与推注热稀释的一致性仍存在争议，是最佳动脉松动部位的选择 经当地伦理委员会批准后，有14名计划进行择期心脏外科手术并接受体外循环的患者入选。使用FloTrac / Vigileo装置通过一条in动脉和一条股动脉常规动脉进行一氧化碳测量，并通过热稀释推注技术插入肺动脉导管以测定一氧化碳。将所有CO索引到身体表面积，得出CI_FEM，CI_RAD和CI_PAC。在CPB之前和之后至少进行四次测量。 总共分析了262数据pais。包括CPB偏置前后的所有数据以及CI PAC与CI_FEM的精度分别为0,09 L min〜（-1）m〜（-2）和±1,01 Lmin〜（-1）m〜（-2） ，百分比误差为40％。对于CI_PAC与CI_RADbias，精度为034 Lmin〜（-1）m〜（-2）和±1,08 Lmin〜（-1）m〜（-2），百分比误差为45％。 CI_FEMvs。 CI_RAD显示出-0.25 Lmin〜（-1）m〜（-2）的偏差和±0.48 Lmin〜（-1）m〜（-2）的精度，导致20％的百分比误差。 CPB之前获得的数据对的亚组分析显示，CI_PAC与CI_FEM和CI_PAC与CI_RAD的百分比误差分别为32％和34％。在CPB之后，CI_PAC与CI_FEM的百分比误差为46％，CI_PAC与CI_RAD的误差为55％。 我们得出结论，用FloTrac / Vigileo™设备测量的CO与热稀释推注方法之间的一致性不足以在CPB心脏麻醉的环境中进行临床诊断和治疗指导。

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