CO2部分重吸入法测心排血量在冠脉搭桥术中的应用

目的 观察CO2部分重吸入法测心排血量在冠脉搭桥术中的应用。方法 选择冠脉搭桥术26例，于诱导后、切皮、体外循环转流前、停转流后60min、停转流90min、术毕及术后监护室各时点采用CO2部分重吸入法测心排血量（RBco)，并与温度稀释法（TDco)作比较。结果 于诱导后、切皮、停转流90min、术毕、术后监护室RBco和TDco测量数值均无显著性差异（P＞0．05），于转流前、转流后60min测量值有显著性差异（P＜0．05）。各时点RBco和TDco相关系数均P＜0．01，其中术后监护室中的相关系数最高，r＝0．8511。结论 CO2部分重吸入法测心排血量在冠脉搭桥术术后监测中有良好的准确度，术中监测也有一定的临床价值。

The use of partial CO2 rebreathing cardiac output measurement during coronary artery bypass surgery

Objective To compare the cardiac output measured by partial CO 2 rebreathing (RBco)with that measured by thermodilution (TDco)during coronary artery bypass surgery Methods Twenty six patients undergoing coronary artery bypass (CAB) surgery were studied Swan Ganz catheter was placed in the operating room before induction of general anethesia After induction of anesthesia partial CO 2 rebreathing cardiac output monitor (NICO 2) was connected Parameters like FiO 2, concentration of inhalational anesthetic, patient's height and weight were fed to the monitor and the length of NICO 2 loop was regulated according to the difference between inhaled and exhaled tidal volume (V T) 15min after the start of NICO 2 monitoring, arterial blood sample was taken and correction was made according to blood gas analysis RBco was recorded after induction of general anesthesia (20min after NICO 2 monitoring was started ), during skin incision, before CPB was started, 60 and 90 min after termination of CPB and at the end of operation RBco was compared with TDco Results There was no significant difference between RBco and TDco after induction of general anesthesia, during skin incision, 90 min after termination of CPB, at the end of operation and in ICU after surgery (P>0 05), while the difference between RBco and TDco was significant before CPB was started and 60min after termination of CPB (P<0 05) Conclusions The partial CO 2 rebreathing cardiac output measurement is reliable in CAB patients after operation in ICU and is also reliable to some extent during operation