ICON无创心输出量监测在感染性休克患者中的准确性研究

Accuracy analysis of noninvasive cardiometer in patients with septic shock

目的探讨无创心输出量监测仪（NICOM）用于感染性休克患者血流动力学监测的准确性。方法选择2016-10～2017-05北京协和医院急诊监护病房（EICU）收治需要行脉搏指示持续心输出量（pulse index continuous cardiac output，PiCCO）监测的感染性休克患者。所有人选患者同时采用NICOM进行血流动力学监测，测量和记录CO、SV、SVRI、dpmax、心肌收缩力。结果NICOM和PiCCO在不同时间段测得的CO、SV、SVRI差异无统计学意义（P〉0．05），且具有相关性（r=0．891，P〈0．05，R^2=0．794；r=0．879，P〈0．05，R^2=0．773；r=0．892，P〈0．05，R^2=0．796）。dpmax和心肌收缩力具有相关性（r=0．762，P〈0．05，R^2=0．581）。结论NICOM可较准确地为患者提供血流动力学监测，有助于患者病情判断及治疗效果的评估。

Objective To explore the accuracy of noninvasive cardiac output monitoring （NICOM） for hemodynamic monitoring in patients with septic shock. Methods We performed a study of patients who were given PiCCO monitoring with septic shock admired to the Emergency Intensive Care Unit of the Peking Union Medical College Hospital from October 2016 to May 2017. All patients received ICON monitoring. We measured and recorded the level of CO, SV, SVRI, dpmax, and ICON. Results There was no significant difference of CO, SV and SVRI between the two methods in different periods （P 〉 0.05 ）. Moreover, the CO, SV and SVRI by the two methods were significantly correlated （ r = 0.891, P〈O. 05, R^2=0.794; r=0.879, P〈0.05, R^2=0.773; r=0.892, P〈0.05, R^2=0.796）. In addition, dPmax and ICON has correlation with each other （ r = 0. 762, P 〈 0.05, R2 = 0. 581 ）. Conclusion NICOM can provide accurate hemodynamic monitor and have great clinical value for diagnosis of septic shock and assessment of therapeutic effect.