侵入性心脏输出和左心室辅助器件流量参数之间的比较
Amitai Segev1, Viana Copeland1, Mateusz Sokolski2
1The Leviev Heart Center, Sheba Medical Center, Ramat-Gan, Israel.
概括
左心室辅助装置 (LVAD) 流量参数与侵入性心脏输出测量,特别是热稀释,相对应得很好. 当低心输出值被排除时,这种相关性会改善,从而提高LVAD监测的准确性.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 医疗器械技术 医疗器械技术
背景情况:
- 左心室辅助器件 (LVAD) 对末期心力衰竭至关重要.
- 在LVAD患者中,精确监测心脏输出 (CO) 对于最佳管理至关重要.
- 设备衍生和侵入性CO测量之间的差异可能会使患者护理复杂化.
研究的目的:
- 为了评估LVAD流量参数与侵入性CO测量之间的相关性.
- 评估不同CO测量方法 (间接Fick,热稀释) 和LVAD流量之间的一致性.
- 为了确定与LVAD患者的CO测量异常相关的因素.
主要方法:
- 对来自两个三级中心的102名LVAD患者的右心导管数据的回顾性分析.
- 使用间接Fick和热稀释对LVAD流量参数进行CO测量的比较.
- 线性回归用于相关性分析,Bland-Altman图表用于协议评估.
- 具有和没有显著的CO测量异常 (≥20%差异) 的患者之间的临床和血液动力学参数的比较.
主要成果:
- 总共有544个测量结果在102名患者中进行了比较.
- 在45%的比较中观察到流量和间接Fick之间的不一致,在48%的比较中观察到热稀释.
- 发现了强烈的相关性:R=0.751 (间接的Fick与LVAD流) 和R=0.789 (热稀释与LVAD流).
- 除了间接Fick CO值的最低三位数外,相关性显著改善 (热稀释:R=0.879;间接Fick:R=0.843).
结论:
- LVAD流量参数提供了合理的心脏输出估计,与间接Fick相对应良好,与热稀释有很强的相关性.
- 排除较低的心力输出值可以提高LVAD流量和侵入性CO测量之间的相关性.
- 这些发现支持LVAD流作为补充CO监测工具的实用性,特别是当与其他参数结合解释并考虑潜在的不一致时.
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