心排血量监测的指示剂稀释技术：基本原理、局限性与展望

对于心脏并发症风险高的危重患者，尤其对于已有心血管并存疾病的患者，心排血量的监测是评估血流动力学的重要基石。30多年来，通过肺动脉导管用快速灌注热稀释法评估心排血量的方法已作为高级血流动力学监测的“临床标准”被广泛认可。本文回顾了这一临床标准，以及目前同样源于指示剂稀释技术的替代方法，如经心肺热稀释和锂稀释技术。这篇综述不但描述了实施每种指示剂稀释法的基本技术原理和各自的特征，还概述了其局限性。

The ability to monitor cardiac output is one of the important cornerstones of hemodynamic assessment tor managing critically ill patients at increased risk for developing cardiac complications, and in particular in patients with preexisting cardiovascular comorbidities. For 〉30 years, single-bolus thermodilution measurement through a pulmonary artery catheter for assessment of cardiac output has been widely accepted as the ＂ clinical standard＂ for advanced hemodynamic monitoring, In this artide, we review this dinical standard, along with current alternatives also based on the indicator-dilution technique, such as the transcardiopulmonary thermodilution and lithium dilution techniques. In this review, not only the underlying technical prindples and the unique features but also the limitations of each application of indicator dilution are outlined.