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首页> 外文期刊>Critical care : >Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices
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Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices

机译：败血病患者基于动脉压的心输出量：脉搏轮廓和未校准压力波形设备的准确性不同

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IntroductionWe compared the ability of two devices estimating cardiac output from arterial pressure-curve analysis to track the changes in cardiac output measured with transpulmonary thermodilution induced by volume expansion and norepinephrine in sepsis patients.MethodsIn 80 patients with septic circulatory failure, we administered volume expansion (40 patients) or introduced/increased norepinephrine (40 patients). We measured the pulse contour-derived cardiac index (CI) provided by the PiCCO device (CIpc), the arterial pressure waveform-derived CI provided by the Vigileo device (CIpw), and the transpulmonary thermodilution CI (CItd) before and after therapeutic interventions.ResultsThe changes in CIpc accurately tracked the changes in CItd induced by volume expansion (bias, -0.20 ± 0.63 L/min/m2) as well as by norepinephrine (bias, -0.05 ± 0.74 L/min/m2). The changes in CIpc accurately detected an increase in CItd ≥ 15% induced by volume expansion and norepinephrine introduction/increase (area under ROC curves, 0.878 (0.736 to 0.960) and 0.924 (0.795 to 0.983), respectively; P < 0.05 versus 0.500 for both). The changes in CIpw were less reliable for tracking the volume-induced changes in CItd (bias, -0.23 ± 0.95 L/min/m2) and norepinephrine-induced changes in CItd (bias, -0.01 ± 1.75 L/min/m2). The changes in CIpw were unable to detect an increase in CItd ≥ 15% induced by volume expansion and norepinephrine introduction/increase (area under ROC curves, 0.564 (0.398 to 0.720) and 0.541 (0.377 to 0.700, respectively, both not significantly different from versus 0.500).ConclusionsThe CIpc was reliable and accurate for assessing the CI changes induced by volume expansion and norepinephrine. By contrast, the CIpw poorly tracked the trends in CI induced by those therapeutic interventions.
机译：简介我们比较了两种设备通过动脉压力曲线分析估算心输出量的能力，以追踪败血症患者经容量膨胀和去甲肾上腺素引起的经肺热稀释测量的心输出量的变化。方法在80例败血症性循环衰竭患者中，我们进行了容量扩展（ 40例患者）或引入/增加的去甲肾上腺素（40例患者）。在治疗干预前后，我们测量了由PiCCO设备（CIpc）提供的脉搏轮廓得出的心脏指数（CI），由Vigileo设备（CIpw）提供的动脉压波形得出的CI和经肺热稀释CI（CItd）。结果CIpc的变化准确地跟踪了体积膨胀（bias，-0.20±0.63 L / min / m2）和去甲肾上腺素（bias，-0.05±0.74 L / min / m2）引起的CItd变化。 CIpc的变化准确地检测到体积膨胀和去甲肾上腺素引入/增加引起的CItd≥15％的增加（ROC曲线下的面积分别为0.878（0.736至0.960）和0.924（0.795至0.983）; P <0.05对0.500都）。 CIpw的变化对于追踪CItd的体积引起的变化（偏倚，-0.23±0.95 L / min / m2）和去甲肾上腺素引起的CItd的变化（偏倚，-0.01±1.75 L / min / m2）不太可靠。 CIpw的变化无法检测到由于体积增加和去甲肾上腺素引入/增加（ROC曲线下的面积分别为0.564（0.398至0.720）和0.541（0.377至0.700）而引起的CItd≥15％的增加，两者与相对于0.500）。结论CIpc能够可靠，准确地评估容量扩张和去甲肾上腺素引起的CI变化，而CIpw不能很好地追踪这些治疗性干预引起的CI趋势。

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