PLos One:热稀释法与Fick法测量老年患者心输出量的比较

2020-01-17 xiangting MedSci原创

尽管CI-eFM与CI-TD总体上具有合理的相关性,但CI-eFM对单个患者的预测价值较低。在老年患者中CI-eFM无法取代CI-TD。

被转诊到导管实验室的老年患者越来越多。热稀释法(TD,金标准)和估算Fick法(eFM)在临床常规测量心输出量(CO)时可互换使用。但是截至目前,两种方法在老年心脏病患者队列中的相关性尚未得到检验。

研究人员于20154月至20178月对通过eFMTD估算CO155例连续性患者(75.1±6.8岁,男性占57.7%)进行单侧、有临床指征的右心导管检查。通过应用LaFargeLaF)、DehmerDe)和BergstraBe)公式假定全身耗氧量(VO2)。CO除以体表面积计算心脏指数(CI)。

CI-TD与由LaFDeBe评估的CI-eFM总体呈中等相关性(分别为r2 = 0.53r2 = 0.54r2 = 0.57p<.001),且一致性区间大(-0.641.09-1.070.77-1.380.53 l/m2/min)。两种方法CI的平均差异分别为0.22-0.15-0.42(对于TD的差异,p<0.001)。使用LaFDeBe方程分别有40.6%、26.5%和36.1%的患者错误率≥20%。根据TD42.6%的患者CI<2.2 l/m2min。通过LaFDeBe公式计算,分别有60.0%、31.0%和16.1%的患者根据eFMCI<2.2 l/m2min

尽管CI-eFMCI-TD总体上具有合理的相关性,但CI-eFM对单个患者的预测价值较低。在老年患者中CI-eFM无法取代CI-TD

原始出处:

Karl-Patrik Kresoja. Thermodilution vs estimated Fick cardiac output measurement in an elderly cohort of patients: A single-centre experience. PLos One. December 2019.

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