传感器位置的微小变化会导致心脏输出读数的系统变化:对临床实践的影响
Caroline Dinesen1,2, Simon Tilma Vistisen2, Peter Juhl-Olsen3,4
1Department of Cardiothoracic- and Vascular Surgery, Aarhus University Hospital, Anesthesia Section, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark.
Journal of clinical monitoring and computing
|October 10, 2024
概括
在传感器位置的小变化显著改变心脏输出 (CO) 测量使用第4代FloTrac软件. 精确的传感器放置对于在重症监护机构的精确血液动力学监测至关重要.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
背景情况:
- 精确的血液动力学监测对于心脏手术后的患者管理至关重要.
- 该FloTrac系统 (第四代) 提供连续的心力输出 (CO) 估计.
- 传感器的定位是影响血液动力学测量的已知因素.
研究的目的:
- 系统地评估微小的垂直传感器位置变化对CO和其他血液动力学变量的影响,这些变量由第四代FloTrac软件测量.
- 为了确定FloTrac CO测量对传感器高度变化的灵敏度.
- 在血液动力学监测中评估这些位置变化的临床意义.
主要方法:
- 一项前性研究,涉及20名心脏手术后的患者.
- 用第四代FloTrac测量心脏输出 (CO),平均动脉压 (MAP),全身血管阻力 (SVR) 和中风体积变化 (SVV).
- 传感器被随机放置在中间轴平面上,比中间轴平面高4厘米或低4厘米.
主要成果:
- 传感器位置的4厘米垂直移动导致了CO的显著变化 (P < 0.001).
- 转换器位置较高时,CO增加了大约4.1%,转换器位置较低时减少了3.4%,平均每厘米约为~1%.
- 随着传感器位置的变化,MAP和SVR也发生了显著的变化 (P < 0.001),而SVV没有受到影响 (P = 0.98).
结论:
- 垂直传感器位置显著影响使用第四代FloTrac软件获得的心脏输出测量.
- 即使是传感器高度的小 (4厘米) 变化也可能导致血液动力学数据的临床显著变化.
- 根据FloTrac数据,对传感器水平和患者定位的细致关注对于可靠的目标导向治疗至关重要.
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