使用无线可穿戴的脉冲分解分析设备进行心脏输出估计与心脏手术后重症监护室患者的持续热稀释之间的协议
Ashish K Khanna1,2,3, Julio O Garcia4, Amit K Saha5,6
1Department of Anesthesiology, Section on Critical Care Medicine, School of Medicine, Wake Forest University, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA. akhanna@wakehealth.edu.
Journal of clinical monitoring and computing
|July 17, 2023
概括
使用脉冲分解分析 (PDA) 的无线可穿戴设备显示,在术后心脏手术患者中,对心脏输出估计有适度的同意. 虽然它不能与肺动脉导管热稀释完全互换,但它提供了一个有希望的非侵入性监测解决方案.
科学领域:
- 心血管生理学心血管生理学
- 医疗器械技术 医疗器械技术
- 密集护理医学 密集护理医学
背景情况:
- 精确的心脏输出 (CO) 监测对于管理重症患者至关重要,特别是心脏手术后.
- 像肺动脉导管 (PAC) 热稀释 (CO-CCO) 这样的传统方法是侵入性的.
- 寻求非侵入性方法来补充或取代侵入性监测.
研究的目的:
- 评估使用脉冲分解分析 (CO-PDA) 的无线可穿戴的非侵入性设备和连续的肺动脉导管 (PAC) 导导热稀释 (CO-CCO) 之间的心脏输出 (CO) 估计的一致性.
- 为了评估CO-PDA测量的准确性和一致性,在术后心脏手术患者在重症监护室 (ICU) 设置.
主要方法:
- 预期招募成人心脏外科ICU患者.
- 使用布兰德-阿尔特曼分析和对应性分析与10%排斥区进行非校准的CO-PDA测量与CO-CCO的比较.
- 在259.7小时的监测中,分析了41名患者的15583个数据点.
主要成果:
- 平均CO-CCO为5.55升/分钟,平均CO-PDA为5.73升/分钟,平均差异为0.79±1.11升/分钟.
- 协议的极限为-1.43至3.01L/min,百分比误差为37.5%.
- 在CO-CCO和CO-PDA之间观察到中度相关性 (0.54) 和一致性 (0.83).
结论:
- 使用CO-PDA的心脏输出测量在使用30%值时不能与CO-CCO Swan-Ganz互换.
- CO-PDA的结果在侵袭性最小的设备的45%的限制内.
- 在等待进一步验证的情况下,CO-PDA为ICU内外的血液动力学监测提供了一个潜在的非侵入性无线解决方案.
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