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首页> 外文学位 >Development of a canine flow probe model to investigate aspects of cardiac monitors and vasopressor therapies that can not be tested clinically.
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Development of a canine flow probe model to investigate aspects of cardiac monitors and vasopressor therapies that can not be tested clinically.

机译：犬流量探针模型的开发，以调查无法在临床上进行测试的心脏监护仪和血管加压药治疗的各个方面。

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摘要

Cardiovascular monitoring and vasopressor therapies are important adjuncts to clinical practice especially in the fields of anaesthesia and critical care. However, the developments of safe and effective methods need rigorous testing that cannot be done solely in the clinical arena because of ethical limitations. In this thesis I developed an anaesthetized canine model in which cardiac output and contractility were measured using a high-performance flow probe placed on the aorta via a left thoracotomy and renal blood flow was measured by a flow probe placed on the left renal artery. This model also provided gold standard measurements of cardiac contractility (dF/dt (max)) from the aortic flow waveform. Arterial and central venous blood pressure was also measured. The circulation of the canine model was manipulated using vasopressor infusions and halothane.;The model enabled me to evaluate: (i) the performance of a new impedance cardiograph, the RheoCardioMonitor; (ii) the performance of a new ultrasonic Doppler cardiac monitor, the USCOM, and (iii) the circulatory effects of five commonly used vasopressor agents on the systemic and renal circulation under normal and septic conditions.;My main findings were that: (i) impedance cardiography cardiac output measurements were affected by changes in peripheral resistance, so that it underestimated at low peripheral resistance and overestimated at high peripheral resistance; (ii) impedance cardiac contractility was better assessed using indices based on the slope of the impedance waveform, rather than the timing intervals of cardiac cycle; (iii) the USCOM reliably detected changes in cardiac output over a wide range of values; and (iv) noradrenaline, which showed a powerful vasopressor effect without decreasing of cardiac output and renal blood flow, was the best choice of vasopressors in septic shock, but the effects of all catecholamine vasopressors were attenuated in septic shock, and with the exception of vasopressin which probably was the alternative choice in refractory septic shock.;In conclusion, the canine flow probe model proved a valuable asset for testing cardiac monitors and evaluating vasopressor therapies, particularly in sepsis. It enabled me to answer a number of clinically relevant questions relating to these devices and therapies, and set up the foundation for future studies.
机译：心血管监测和血管加压治疗是临床实践的重要辅助手段，尤其是在麻醉和重症监护领域。但是，安全和有效方法的发展需要严格的测试，由于伦理上的限制，这些测试不能仅在临床上进行。在本论文中，我开发了一种麻醉犬模型，其中，通过左胸廓切开术使用放置在主动脉上的高性能流量探针测量心输出量和收缩力，并使用放置在左肾动脉上的流量探针测量肾血流量。该模型还根据主动脉血流波形提供了心脏收缩力的黄金标准测量值（dF / dt（max））。还测量了动脉和中央静脉血压。使用血管加压药和氟烷来控制犬模型的循环。该模型使我能够评估：（i）新型阻抗心电图仪RheoCardioMonitor的性能； （ii）新型超声多普勒心脏监护仪（USCOM）的性能，以及（iii）在正常和脓毒症条件下，五种常用血管升压药对全身和肾脏循环的循环作用；我的主要发现是： ）阻抗心动图心输出量测量受外围电阻变化的影响，因此在低外围电阻时会低估，在高外围电阻时会过高； （ii）使用基于阻抗波形斜率而不是心动周期的时间间隔的指数更好地评估阻抗心收缩性； （iii）USCOM在各种值上可靠地检测到心输出量的变化； （iv）去甲肾上腺素在败血性休克中显示出强大的血管升压作用而不降低心输出量和肾血流量，是败血性休克中血管升压药的最佳选择，但在败血性休克中，所有儿茶酚胺升压药的作用均减弱，除了血管加压素可能是难治性败血症性休克的替代选择。总之，犬流探针模型被证明对于测试心脏监护仪和评估血管加压药的治疗，特别是在败血症中具有宝贵的价值。它使我能够回答与这些器械和疗法有关的许多临床相关问题，并为以后的研究奠定了基础。

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  • 作者

    Peng, Zhiyong.;

  • 作者单位

    The Chinese University of Hong Kong (Hong Kong).;

  • 授予单位 The Chinese University of Hong Kong (Hong Kong).;
  • 学科 Health Sciences Medicine and Surgery.;Biophysics Medical.
  • 学位 Ph.D.
  • 年度 2005
  • 页码 175 p.
  • 总页数 175
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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