CAJ | 학술논문

目的探讨生物电阻抗法测量无创心输出量(CO)在危重病中应用的准确性和有效性.方法选择2008年1月至5月间本院外科重症监护中心(SICU)收治的12例需放置SWAN-GANZ导管进行血流动力学监测的患者,同时用生物电阻抗法和SWAN-GANZ导管热稀释法测定患者CO曲线平稳后0、1、6、12、24、48 h的CO值,并应用Pearson相关对两种方法测得的CO值与时间进行分析.结果生物电阻抗法测最的CO值在所有时间点均低于SWAN-GANZ导管热稀释法的测最值[0 h:(5.5±0.9)L/min比(7.7±1.4)L/min;1h:(5.3±0.7)L/min比(7.4±1.5)L/min;6 h:(4.6±0.6)L/min比(6.8±1.4)L/min;12 h:(5.1±0.9)L/min比(7.6±1.6)L/min;24 h:(6.1±1.1)L/min比(9.0±1.6)L/min;48 h:(6.3±1.3)L/min比(9.5±1.5)L/min;均P<0.05].两种方法测量的CO值均随着时间的延长而呈升高趋势(r=0.818,P=0.047和r=0.884,P=0.020).结论生物电阻抗法测量的无创CO与SWAN-GANZ导管测定的患者CO同样呈时间依赖性,是一种有效的CO监测方法.
목적 탐토생물전조항법측량무창심수출량(CO)재위중병중응용적준학성화유효성.방법 선택2008년1월지5월간본원외과중증감호중심(SICU)수치적12례수방치SWAN-GANZ도관진행혈류동역학감측적환자,동시용생물전조항법화SWAN-GANZ도관열희석법측정환자CO곡선평은후0、1、6、12、24、48 h적CO치,병응용Pearson상관대량충방법측득적CO치여시간진행분석.결과 생물전조항법측최적CO치재소유시간점균저우SWAN-GANZ도관열희석법적측최치[0 h:(5.5±0.9)L/min비(7.7±1.4)L/min;1h:(5.3±0.7)L/min비(7.4±1.5)L/min;6 h:(4.6±0.6)L/min비(6.8±1.4)L/min;12 h:(5.1±0.9)L/min비(7.6±1.6)L/min;24 h:(6.1±1.1)L/min비(9.0±1.6)L/min;48 h:(6.3±1.3)L/min비(9.5±1.5)L/min;균P<0.05].량충방법측량적CO치균수착시간적연장이정승고추세(r=0.818,P=0.047화r=0.884,P=0.020).결론 생물전조항법측량적무창CO여SWAN-GANZ도관측정적환자CO동양정시간의뢰성,시일충유효적CO감측방법.
Objective To evaluate the efficacy and accuracy of non-invasive bioelectrical impedance measurement of cardiac output (CO) in critically ill patients. Methods Between January and May 2008, 12 patients who needed hemodynamics monitoring using SWAN-GANZ catheterization in surgical intensive care unit (SICU) of our hospital were measured for CO by bioelectrical impedance and SWAN-GANZ catheterization thermodilution approaches. These values were recorded at 0, 1, 6, 12, 24 and 48 hours after the CO curve became stable in these patients. Pearson correlation analysis was performed for CO values over time recorded by these two approaches. Results At all the time points, CO measurement by bioelectrical impedance yielded lower values than those by SWAN-GANZ catheterization thermodilution approach [0 h: (5.5±0.9) L/min vs (7.7±1.4) L/min; 1 h: (5.3±0.7) L/min vs (7.4±1.5) L/min; 6 h: (4.6±0.6) L/min vs (6.8±1.4) L/min; 12 h: (5.1±0.9) L/min vs (7.6±1.6) L/min; 24 h: (6.1± 1.1) L/min vs (9.0±1.6) L/min;48 h: (6.3±1.3) L/min vs (9.5±1.5) L/min; all P<0.05]. During continuous monitoring by either bioelectrical impedance or SWAN- GANZ catheterization thermodilution, all the CO values showed an increasing trend along with time (r=0.818, P=0.047 in bioelectrical impedance group and r=0.884, P=0.020 in SWAN-GANZ catheterization thermodilution group). Conclusion Like those measured by SWAN-GANZ catheterization thermodilution, the CO measured by non-invasive bioelectrical impedance appears time-dependent, and therefore can be considered as an effective approach in CO monitoring.