使用基于外围动脉导管的波形来估计心脏输出的Edwards Acumen IQ系统与狗的热稀释相比不准确
American journal of veterinary research
|February 9, 2024
概括
与狗的热稀释相比,Edwards Acumen IQ传感器 (HS-IQ) 系统用于估计心脏输出 (CO) 显示了广泛的协议限制. 目前的HS-IQ CO估计不适合临床应用.
科学领域:
- 心血管生理学心血管生理学
- 医疗器械评估 医疗器械评估
- 麻醉学 麻醉学
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.
- 对CO估计的非侵入性方法正在不断开发,以改善患者护理.
- 爱德华兹的Acumen IQ传感器和HemoSphere高级监测平台 (HS-IQ) 是一种用于CO估计的新型系统.
研究的目的:
- 评估HS-IQ系统估计的心脏输出量 (CO) 与通过热稀释 (TD) 测量的狗之间的一致性.
- 为了评估HS-IQ CO测量的精度,无论是辐射和背侧甲动脉.
主要方法:
- 八只专门繁殖的比格尔犬被麻醉并用动脉导管进行仪器仪表.
- 用TD和HS-IQ系统测量了心脏输出,用于辐射和背甲动脉部位.
- 在normovolemic和hypovolemic状态下进行测量,使用Bland-Altman方法分析,可接受的LOA<30%.
主要成果:
- 总共分析了21个 (辐射) 和24个 (脊椎甲足) 配对的CO测量结果.
- 辐射动脉HS-IQ与TD的偏差为-0.09 L/min,共识范围很大 (-2.66 到 2.49 L/min).
- 背甲动脉HS-IQ与TD的偏差为-0.26L/分钟,具有广泛的协议边界 (-2.76至2.24L/分钟).
结论:
- 使用HS-IQ系统进行心脏输出估计在技术上是可行的,但结果超出了临床上可接受的范围.
- 广泛的共识限制表明,HS-IQ CO估计目前不适合临床使用.
- 在临床应用之前需要进一步验证和潜在的系统改进.
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