课件：血流动力学监测ICCO杜斌.ppt

中心静脉插管部位的影响 颈内静脉, sec 股静脉, sec P MTt 43.4 ? 18.9 46.6 ? 18.3 0.0068 DSt 23.3 ? 15.2 24.1 ? 13.5 0.35 AUC 6.5 ? 2.5 6.6 ? 2.6 0.27 Schmidt S, Westhoff TH, Hofmann C, Schaefer J-H, Zidek W, Compton F, van der Giet M. Effect of the venous catheter site on transpulmonary thermodilution measurement variables. Crit Care Med 2007; 35: 783-786 中心静脉插管部位的影响 颈内静脉 股静脉 差异% P ITBVI (ml/m2) 1059 1345 27 .001 EVLWI (ml/kg) 14.2 15.8 12 .049 CI (L/min/m2) 4.05 4.06 1 .92 Grundler S, Macchiavello L. Femoral central venous catheter (CVC) versus internal jugular CVC for assessment of haemodynamic parameters by transpulmonary thermodilution using pulse contour cardiac output. Critical Care 2005; 9(Suppl 1): P64 (DOI 10.1186/cc3127) 肾脏替代治疗对PICCO测定的影响 24名危重病患者(男性15名, 女性9名) 血流动力学监测 5-F股动脉插管(PV2015L20; Pulsion Medical Systems) 肾脏替代治疗 12-F股静脉血透插管(Trilyse Expert; Vygon) (n = 12) 12-F上腔静脉血透插管(n = 12) 测定部位: 上腔静脉插管(Certofix Trio; Braun, Melsungen) 测定时间: RRT过程中, 终止RRT即刻, 重新开始后即刻 Sakka S, Hanusch T, Thuemer O, Wegscheider K. Influence of veno-venous renal replacement therapy on transpulmonary thermodilution measurements. Critical Care 2006; 10(Suppl 1): P355 (doi: 10.1186/cc4702) 肾脏替代治疗对PICCO测定的影响 RRT No RRT RRT HR (bpm) 99 ? 27 100 ? 27 99 ? 27 MAP (mmHg) 74 ? 14 76 ? 12 74 ? 13 CVP (mmHg) 14 ? 4 14 ? 4 14 ? 4 CI (L/min/m2) 3.8 ? 1.4 3.9 ? 1.3 3.8 ? 1.3 ITBVI (ml/m2) 934 ? 254 945 ? 255 920 ? 247 EVLWI (ml/kg) 8.3 ? 3.7 8.3 ? 3.6 8.4 ? 3.6 Sakka S, Hanusch T, Thuemer O, Wegscheider K. Influence of veno-venous renal replacement therapy on transpulmonary thermodilution measurements. Critical Care 2006; 10(Suppl 1): P355 (doi: 10.1186/cc4702) 肾脏替代治疗对PICCO测定的影响 在肾脏替代治疗过程中 CI降低 (平均改变-0.1 L/min/m2, P 0.01) ITBVI降低 (平均改变-18 ml/m2, P = 0.02) EVLWI不变 (平均改变+0.1 ml/kg, P = 0.42) Sakka S, Hanusch T, Thuemer O, Wegscheider K. Influence of veno-venous renal replacement therapy on transpulmonary thermodilution measurements. Critical Care 2006; 10(Suppl 1): P355 (doi: 10.1186/cc4702) 肾脏替代治疗对PICCO测定的影响 Mason