在小儿心脏手术后使用心声回声和PiCCOCO进行血液动力学监测
Fredrik Pernbro1,2, Håkan Wåhlander3,4, Birgitta Romlin1,2
1Department of Paediatric Anaesthesiology and Intensive Care, University of Gothenburg, Institute of Clinical Sciences, Gothenburg, Sweden.
Cardiology in the young
|October 14, 2024
概括
儿科心脏手术后心脏输出监测显示,心声回声和肺间热稀释 (PiCCOTM) 之间的平均一致性很好. 然而,由于结果的广泛变化,人们对其可互换的临床用途提出了质疑.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 关键护理医学 关键护理医学
- 医疗器械技术 医疗器械技术
背景情况:
- 血液动力学不稳定性是儿科先天性心脏缺陷 (CHD) 修复后的常见问题.
- 随着传统的参数,心脏输出监测可以增强术后护理.
- 心声学和肺间热稀释是婴儿心脏输出测量的主要方法.
研究的目的:
- 为了比较心脏输出测量从心声回声和肺间热稀释 (PiCCOTM) 后儿科心脏手术.
- 评估这两种心脏输出监测技术的一致性和临床适用性.
主要方法:
- 一项前性观察性研究,涉及40名接受选择性隔膜缺陷修复的儿童.
- 在手术后18小时使用心声学和PiCCOTM同时测量心脏输出量.
- 纳入标准:选择性心室隔膜缺陷或通过心肺绕道修复心室隔膜缺陷.
主要成果:
- PiCCOTM报告了心脏平均输出比心声回声学高3.0%,这种差异在统计学上并不显著.
- 达成一致的95%极限范围广泛地从-50.0%到82.6%不等.
- 平均而言,两种方法之间没有发现统计学上显著的差异.
结论:
- 心声和PiCCOTM显示了儿童心脏外科手术后患者心脏输出测量的良好平均一致性.
- 个体测量的实质性变化引发了人们对这些方法在临床实践中的可互换性的担忧.
- 可能需要进一步的研究来完善这些技术的使用,以实现可靠的,个性化的患者管理.
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