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首页> 外文期刊>Resuscitation. >A new noninvasive method to determine central venous pressure.
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A new noninvasive method to determine central venous pressure.

机译：一种确定中心静脉压的新型无创方法。

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摘要

Knowledge of central venous pressure (CVP) is considered valuable in the assessment and treatment of various states of critical illness and injury. OBJECTIVES: We tested a noninvasive means of determining CVP (NICVP), by monitoring forearm volume changes in response to externally applied circumferential pressure to the upper arm veins. METHODS: Sixteen patients who were undergoing CVP monitoring as a part of their care had NICVP determined and compared with CVP. Volume changes were measured in the forearm with mercury-in-silastic strain gauge plethysmography. A pressure cuff is placed in the upper extremity. The cuff is inflated over 5s to a pressure above CVP but below diastolic arterial pressure (40 mmHg). This allows blood into the forearm but prevents venous return. After 45-60 s the cuff is rapidly deflated. NICVP was determined as the cuff pressure noted at the maximum derivative of the forearm volume decrease during deflation. NICVP was then compared to invasively measured CVP taken during the same period. RESULTS: A total of 48 trials (three per subject) were performed on 16 patients. The range of CVP recorded was 0-22 mmHg. The correlation between CVP and NICVP was 0.98 (95% CI: 0.95-0.98) (p<0.001). The bias between methods was 0.26 mmHg with the limits of agreement being 3.4 to -2.89 mmHg. When the average of three trials per patients was analysed the bias stayed at 0.26 mmHg but the limits of agreement improved to 2.54 and -2.03 mmHg. CONCLUSION: NICVP as determined in this study may be a clinically useful substitute for traditional CVP measurement and may offer a valid tool for early diagnosis and treatment of acute states in which knowledge of CVP would be helpful.
机译：中心静脉压（CVP）的知识被认为在评估和治疗严重疾病和伤害的各种状态方面很有价值。目的：我们通过监测前臂体积变化（响应于外部施加到上臂静脉的圆周压力）来测试确定CVP（NICVP）的无创方法。方法：对16例接受CVP监护的患者进行了NICVP测定，并将其与CVP进行比较。体积变化是在前臂中使用水银-硅弹性应变片体积描记法测量的。压力袖带放置在上肢。将袖带充气5秒钟以上，使其压力高于CVP但低于舒张动脉压（40 mmHg）。这样可以使血液进入前臂，但防止静脉回流。 45-60 s后，袖带迅速放气。 NICVP被确定为在放气期间前臂容量减少的最大导数处记录的袖带压力。然后将NICVP与同期测量的侵入式CVP进行比较。结果：总共对16名患者进行了48项试验（每名受试者3项）。记录的CVP范围是0-22 mmHg。 CVP和NICVP之间的相关性为0.98（95％CI：0.95-0.98）（p <0.001）。方法之间的偏差为0.26 mmHg，一致极限为3.4至-2.89 mmHg。当分析每位患者的三项试验的平均值时，偏倚保持在0.26 mmHg，但一致性限制提高到2.54和-2.03 mmHg。结论：本研究确定的NICVP可能是传统CVP测量的临床有用替代品，并且可能为急性状态的早期诊断和治疗提供有效的工具，其中CVP知识将有所帮助。

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