部分二氧化碳重复吸入法与温度稀释法测定心排血量的相关性研究

The correlation between partial CO_2 rebreathing and thermodilution for cardiac output monitoring

目的 研究部分二氧化碳重复吸入法和温度稀释法监测心排血量 (CO)的相关性。方法 重症监护病房 (ICU) 1 5例危重患者 ,在呼吸机辅助控制通气条件下 ,采用美国无创心肺功能监测仪 (NICO)用部分二氧化碳重复吸入法 (RB)连续监测无创心排血量 (RBco) ,并同时采用温度稀释法测定心排血量 (TDco) ,两种方法所测CO值进行自体配对相关性研究。结果 配对t检验示两种方法测定的CO值无显著性差异 (P >0 0 5 ) ,相关回归分析示相关系数为 0 90 ,回归方程为RBco =0 81TDco +1 2 5 ,偏离为 0 2 0 ,精确度为 0 78。结论 部分二氧化碳重复吸入是一种简便、快捷、连续、无创的CO测定方法 ,该法与温度稀释法有良好的相关性 ;在无条件行肺动脉漂浮导管插入有创心功能监测的医院 。

Objective To evaluate the correlation between the methods of partial CO 2 rebreathing and thermodilution for cardiac output measurement.Methods Fifteen critical patients receiving mechanical ventilation were studied.Each patient was instrumented with a pulmonary artery thermodilution(TD)cathether and a partial CO 2 rebreathing(RB)ventilator circuit.Cardiac output was measured simultaneouly by RB and TD methods.Paired t test and regression statistics were used to compare the degree of agreement between concurrent measurements of TDco and RBco.Results Paired t test analysis revealed no significant difference between RBco and TDco measurements.Regression analysis gave an r= 0 90 with a slop of 0 81 and an offset of 1 25L/min.Bland Altman analysis resulted in a bias of 0 20 L/min with a precision(ISD)of 0 78L/min.Conclusion There is a high correlation between RBco and TDco measurements.Partial CO 2 rebreathing is a simple noninvasive and automatic method for CO measurement. [