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首页> 外文期刊>Journal of intensive care medicine >Comparing thermodilution and fick cardiac outputs: should I buy an edsel or a yugo?
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Comparing thermodilution and fick cardiac outputs: should I buy an edsel or a yugo?

机译：比较热稀释和心跳输出：我应该买毛绒玩具还是柚子？

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In this issue of the Journal of Intensive Care Medicine, Dr Baylor compares concurrent cardiac outputs obtained using two different methods: the traditional indicator method using thermodilution versus the Fick method using oxygen consumption determined by indirect calorimetry. Although this was a small clinical study with only 30 patients, Dr Baylor took care to minimize error and performed all procedures with rigor according to established guidelines. The cardiac outputs measured by the two different methods were not strictly simultaneous but were obtained as closely together as possible under consistent clinical conditions. The mean cardiac output obtained by thermodilution was 6.78 L/min and by Fick 7.12 L/min. Although this difference of 0.34 L/min among the mean for 30 patients seems pretty good, only 17 of 30 of the individual paired measurements were within 20% of each other. Dr Baylor included a Bland-Altman analysis to assess agreement between the two methods of cardiac output measurement (Figure 2 in his article) and concluded that the difference was clinically significant. He further concluded that given the known limitations and well-described inherent error of both methods, the lack of agreement is not surprising. Many previous reports have described similar findings and provide elegant explanations for the differences, including the exclusion of the oxygen utilization of the pulmonary circuit inherent to the Fick method [1-3].
机译：在本期《重症监护杂志》中，Baylor博士比较了通过两种不同方法获得的并发心输出量：使用热稀释的传统指示剂方法与使用间接量热法测定的耗氧量的Fick方法。尽管这是一项只有30例患者的小型临床研究，但Baylor博士仍注意将错误降到最低，并按照既定指南严格执行所有程序。通过两种不同方法测量的心输出量并非严格同时进行，而是在一致的临床条件下尽可能紧密地获得。通过热稀释获得的平均心输出量为6.78 L / min，通过Fick获得的平均心输出量为7.12 L / min。尽管30位患者的平均值之间的这种0.34 L / min的差异看起来相当不错，但在30个个体配对测量中，只有17个在彼此的20％之内。 Baylor博士进行了Bland-Altman分析，以评估两种心输出量测量方法之间的一致性（他的文章中的图2），并得出结论，这种差异具有临床意义。他进一步得出结论，鉴于这两种方法的已知局限性和众所周知的固有误差，缺乏一致就不足为奇了。以前的许多报道都描述了类似的发现，并为差异提供了优雅的解释，包括排除了Fick方法固有的肺循环的氧气利用[1-3]。

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