心脏瓣膜手术期间CCO与TCO的一致性变化

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The agreement between continuous and bolus thermodilution cardiac output measurements during cardiac valve surgery

Objective To study the agreement between continuous cardiac output(CCO) and traditional thermodilution cardiac output(TCO) during anesthesia and operation in patients undergoing cardiac valve surgery.Methods The CCO and TCO were measured in 20 patients undergoing cardiac valve procedure with pulmonary catheter technique and Baxter Vigilance monitor and HP M1166A system.The data were processed with bias analysis.Results One hundred and fifty seven pairs of data were obtained altogether.The mean values of TCO and CCO were 3.57 and 3.62L/min respectively,with the correlation coefficient 0.68(P<0.01),bias-0.05L/min,precision 1.04L/min,95% limit agreement -2.13 2.03L/min and relative measure error 9.9%.Before and after cardiopulmonary bypass(CPB),TCO were well correlated to CCO(P<0.01,r=0.72 and 0.57),and the bias and precision were different significantly(-0.29 versus 0.40L/min and 0.75 versus 1.33L/min,P<0.01),the 95% limit agreement and relative measurement errors were -1.80 1.22 versus -2.26 3.06L/min and 10.3% versus 10.0% respectively.The precision and relative error were better at catheterization of aorta and before the beginning of CPB,and worse 10 min after termination of CPB.Conclusion CCO monitor can be accepteble during cardiac surgery.