臨床環境で推定された休息時の酸素摂取量の不正確さ

Nikhil Narang¹, Jennifer T Thibodeau, Benjamin D Levine

¹Department of Medicine, University of Chicago, Chicago, IL (N.N.); Department of Internal Medicine (J.T.T., B.D.L., M.O.G., A.T.T., J.A.d.L.,D.K.M.) and Cardiovascular Division (J.T.T., B.D.L., M.O.G., A.T.T., J.A.d.L., D.K.M.), the University of Texas Southwestern Medical Center, Dallas, TX; Institute of Exercise and Environmental Medicine at the Texas Health Presbyterian Hospital, Dallas, TX (B.D.L.); the Department of Clinical Sciences at the University of Texas Southwestern Medical Center, Dallas, TX (C.R.A., D.K.M.); Cardiology Division, University of Texas Health Science Center at San Antonio, San Antonio, TX (R.A.L.); and the Cardiovascular Division, Oregon Health and Science University, Portland, OR (J.E.C.).

Circulation

|October 1, 2013

まとめ

標準的な式を用いて休息時の酸素摂取量 (O2) を推定することは,特に重度の肥満患者の場合,信頼性が低い. 臨床意思決定における正確な血液動力学的評価のために,O2の直接測定が推奨されます.

科学分野:

心血管生理学心血管の生理学
臨床測定科学とは

背景:

フィック原理は,臨床での心臓の出力量を決定する上で極めて重要です.
酸素摂取量 (O2) を推定することは,測定の複雑さのために一般的ですが,その正確性は疑問です.

研究の目的:

休息時の酸素摂取量 (O2) を推定するための一般的に使用される公式の精度を評価する.
推定O2値を,多様な患者集団で直接測定された値と比較する.

主な方法:

休息時のO2は,ダグラス・バッグ・テクニックを用いて,心臓の右側キャセテリゼーションを受けている535人の成人の患者で測定した.
O2の推定には3つの公式が用いられ,測定値との一致性が評価された.
分析は,ボディマス指数,性別,年齢を考慮した.

主要な成果:

測定されたO2値は,すべての推定値 (P<0.0001) と著しく異なっていた.
配方によって,患者の17-25%で差異は25%を超えました.
不正確な推定値は,重度の肥満患者 (BMI>40 kg/m2) でより顕著でした.

結論:

休息時のO2を推定するための従来の式は,特に重度の肥満の個体では不正確です.
O2の直接測定は,正確な血液動力学的評価と臨床的意思決定に不可欠です.

キーワード:

心臓の出力量は,心臓の出力量です.カテーテリゼーションカテーテリゼーションヘモダイナミクス (血動力学)

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