经肺热稀释法与肺动脉热稀释法测定猪心排血量的一致性

目的 评价经肺热稀释法与肺动脉热稀释法测定猪心排血量(CO)的一致性.方法对13只未成年猪,麻醉诱导后气管插管,机械通气,通过设定的方法依次进行血液动力学干预,于每次干预前及干预过程中血液动力学稳定至少10 min时,同时采用经肺热稀释法和肺动脉热稀释法测定CO(COTP,COPA).采用Bland-Altman法进行一致性分析,设定两种测定方法可以互换的界限为COTP 的相对误差<20%.结果 共收集205对CO数据,COTP范围为1.4～7.06 L/min,COPA范围为1.25～6.55 L/min,COTP值比COPA值高约2%;COTP的偏离度为0.07 L/min,95%可信区间(CI)为0.03～0.11 L/min;一致性范围为-0.46～0.60 L/min,其下限的95%CI为-0.53～-0.40 L/min,其上限的95%CI为0.54～0.66 L/min;COTP的相对误差为15.3%.结论 经肺热稀释法和肺动脉热稀释法测定猪CO具有良好的一致性.

Agreement between transpulmonary thermodilution and pulmonary artery catheter thermodilution cardiac output measurements in pigs

Objective To evaluate the agreement between transpulmonary thermodilution and pulmonary artery catheter thermodilution cardiac output(CO)measurements in pigs.Methods Thirteen immature pigs weighing 22-25 kg were studied.Tracheal intubation was performed and the animals were mechanically ventilated after induction of anesthesia.In each animal,some predetermined methods were used in turn to intervene in the hemodynamics.CO measurements were performed simultaneously by transpulmonary thermodilution(COTP)and pulmonary artery catheter thermodilution(COPA)immediately before intervention and at least 10 min following stable hemodynamics during each intervention.The agreement was assessed using Bland-Ahman analysis,and the interchangeable limits of the two methods were defined as the relative error of COTP less than 20%.Results CO measurements yielded a total of 205 data pairs with a range of 1.4-7.06 L/min for COTP and 1.25-6.55 L/min for COPA and the value of COTP was about 2% higher than that of COPA.The bias of COTP was 0.07 L/min and 95% confidence intenral(CI)was 0.03-0.11 L/min;the limit of agreement was-0.46-0.60 L/min and 95% CI for the lower and upper hmits of agreement was-0.53--0.40 L/min and 0.54-0.66 L/min respectively.The relative error of COTP was 15.3%.Conclusion There is a good agreement between transpulmonary thermodilution and pulmonary artery catheter thermodilution CO measurements in pigs.