Validation of continuous cardiac output technologies consensus still awaited 英文参考文献.docVIP

Available online /content/13/3/159 Commentary Validation of continuous cardiac output technologies: consensus still awaited Maurizio Cecconi and Andrew Rhodes Department of General Intensive Care, St George’s Hospital, Tooting, London, SW17 0QT, UK Corresponding author: Andrew Rhodes, arhodes@sgul.ac.uk Published: 26 June 2009 Critical Care 2009, 13:159 (doi:10.1186/cc7909) This article is online at /content/13/3/159 ? 2009 BioMed Central Ltd See related research by Marque et al., /content/13/3/R73 Abstract signals across the thorax. If this were to work then it would be an almost completely non-invasive method for monitoring changes in cardiac output. An ability to measure cardiac output in a continuous and non- invasive fashion is eagerly awaited in the field of intensive care practice. Modern technologies purport to be able to do this, but the design of studies that validate the manufacturers’ claims is by no means straightforward. It is imperative that the scientific community describes and agrees on a set of principles that will enable us to design and then review and assess future validation studies, so that new technologies can be fairly assessed and compared with their competitors. This statistical analysis deserves some attention. The authors correctly suggest that it is more important for continuous data to track changes accurately than it is for them to be precise measurements of the underlying variable. Indeed, this is how they are used in clinical practice. It is important to under- stand, however, that the absolute value must also be valid- ated; otherwise the tool may be used inappropriately. This requires intermittent measurements that can be compared against a recognized reference. In most cases this would be intermittent thermodilution from the pulmonary artery catheter. Without this the monitor may be shown to trac