经左心温度稀释法测定心排血量新型导管的应用研究

目的:介绍一种新型经左心使用温度稀释法测量心排血量(CO)的导管和方法。方法:健康杂种犬8只,采用自身对照,经右心使用肺动脉气囊漂浮导管,经动脉使用自制的左心测定管,其放置部位分两种情况:前端在左心室内和在主动脉根部。在控制呼吸、停呼吸、控制性降压中、控制性降压后5min四种情况下同时测量心排血量。结果:肺动脉导管与左心导管在两种不同部位情况下测得CO呈正相关,γ分别为0.986和0.989,心脏指数(CI)也呈正相关,γ分别为0.983和0.985;左心导管在两种不同部位情况下所测CO之间与CI之间也显著相关,γ分别为0.992、0.988。结论:制作的左心测定管所测心排血量与肺动脉气囊漂浮导管所测值之间有良好相关性,且设计简单,操作方便。

左心导管测量心排血量的实验研究

目的介绍一种新型经左心使用温度稀释法测量心排血量(CO)的导管和方法。方法健康杂种犬8只,采用自身对照,经右心使用肺动脉气囊漂浮导管,经动脉使用自制的左心测定管。其放置部位分前端在左心室内和在主动脉根部两种情况。在控制呼吸、停呼吸、控制性降压中、控制性降压后5min同时测量CO和心脏指数(CI)。结果在四个时点经左右心两种导管所测值之间差异无统计学意义,且肺动脉导管与左心导管在两种情况下测得CO呈正相关(γ为0.986和0.989),CI也呈正相关(γ为0.983和0.985);左心导管两种情况下所测CO与CI之间也显著相关(γ为0.992和0.988)。结论新型左心测定管所测CO与肺动脉气囊漂浮导管所测值之间有良好相关性,且设计简单,操作方便。

A review in emergency central venous catheterization

Central venous catheterization is widely used in the emergency setting. This review aims to assess central venous catheterization from the perspectives of types of catheters, sites of insertion, and tech- niques. In emergency conditions, non-tunneled catheters are preferred because the technique for its insertion is not complicated and less time-consuming. The size of catheter depends on the purpose of catheterization. For example, a large bore catheter is needed for rapid infusion. The ideal catheterization site should bear fewer thromboses, lower infectious rate, and fewer mechanical complications. Thus the femoral vein should be avoided due to a high rate of colonization and thrombosis while the subclavian vein seems to exhibit fewer infectious complications compared with other sites. The ultrasound-guided technique increases the success rate of insertion while decreases the mechanical complications rate,