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通过血液动力学状态对三种胸前回声心脏成像技术进行心脏输出和中风体积评估的比较评估
Lei Wang1, Da-Wei Wang1, Rui-Ming Xu1
1Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
概括
左心室外流管速度-时间积分 (LVOT/VTI) 方法在不稳定的患者中准确地测量心脏输出量 (CO) 和中风体积 (SV). 这种跨胸心回声心脏成像技术是血液动力学监测中最可靠的非侵入性选择.
科学领域:
- 关键护理医学 关键护理医学
- 心血管成像 - 心血管成像
- 血液动力学监测 血液动力学监测
背景情况:
- 血液动力学不稳定的患者需要精确的心脏输出 (CO) 和中风体积 (SV) 监测.
- 胸外心声学 (TTE) 提供非侵入性评估,但准确性因方法而异.
- 脉冲指数连续心力输出 (PiCCO) 作为血液动力学测量的参考标准.
研究的目的:
- 为了比较三种TTE技术的准确性,分数缩短 (FS),LVOT速度-时间积分 (LVOT/VTI) 和辛普森测量CO和SV的方法.
- 评估这些TTE方法在血液动力学不稳定的患者 (静脉压<90 mmHg).
- 确定在重症监护机构中对CO和SV评估的最可靠的TTE方法.
主要方法:
- 对12名紧急重症监护病房患者的回顾性分析.
- 54次心声回声检查与同时进行的PiCCO测量进行了比较.
- 使用统计相关性方法分析FS,LVOT/VTI的准确性,以及与PiCCO.CO.相比的辛普森方法.
主要成果:
- 所有TTE方法都估计了CO和SV,其中LVOT/VTI显示了最高的整体准确性 (CO-VTI与CO-PiCCO:r=0.950,p<0.001).
- 即使在减少的CO条件下 (r=0.606,p=0.006),LVOT/VTI也保持了卓越的可靠性.
- 辛普森的方法显示精度不佳 (SV-Simpson与SV-PiCCO:r=0.408,p=0.083),LVOT/VTI性能在不同的SV和心率中是一致的.
结论:
- LVOT/VTI方法是最准确和一致的非侵入性技术,用于测量重症患者的SV和CO.
- 建议使用LVOT/VTI作为该人群血液动力学评估的首选方法.
- 这一发现支持了TTE,特别是LVOT/VTI在指导重症监护管理方面的有用性.
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