血流动力学监测进展.pptVIP

血流动力学监测进展;History of Monitoring;;一、无创血流动力学监测;（一）心阻抗血流图;Figure１: Application of electrodes in impedance cardiography ;Impedance cardiography (ICG) is a safe, non-invasive method to measure a patients hemodynamic status. The ICG waveform is generated by thoracic electrical bioimpedance (TEB) technology, which measures the level of change in impedance in the thoracic fluid. Four small sensors send and receive a low amplitude electrical current through the thorax to detect the level of change in resistance in the thoracic fluid. With each cardiac cycle, fluid levels change, which affects the impedance to the electrical signal transmitted by the sensors.;;Figure 7: Variation of ventricular, aortic and atrial pressure, aortic flow, thoracic impedance change and fist derivative of impedance (dz/dt) as a function of time (t). ECG and phonocardiogram taken simultaneously is also shown. 　　The curve depicts the cardiac events / performance. B – Opening of the Aortic Valve, X – Closure of the Aortic Valve, Y – closure of pulmonary valve, O – mitral valve opening/rapid ventricular filling, B-X – Ventricular Ejection Time (VET), C – Maximal deflection of dz/dt (Peak Flow), B-C slope – Acceleration Contractility Index, A – Atrial Systole, Q – Start of ventricular depolarization;Philips Impedance Cardiography (ICG) continuously measures hemodynamic parameters without the associated risks of traditional invasive methods. ? The Philips ICG measurement is ideal for hemodynamic evaluation of adult patients in: 　Emergency departments 　Step-down units 　Special procedure ;Using ICG for the appropriate patient populationThe ICG measurement is designed for assessment of most adult patients – height 122-229 cm (4′-7′6?) and weight 30-159 kg (67-350 lb) – but may demonstrate reduced accuracy when patients present with the following conditions or anomalies:;ICG是一项无创伤性的方法，操作简单、费用低、安全。可动态连续监测CO及与其有关的血流动力学参数，最新研制的阻抗血流图仪能显示和打印16个测定和计算参数及心功能诊断和治疗图。 ICG 由于其抗干扰能力差, 易受病人呼吸、心律失常及手术操作等的干扰, 尤其是不能鉴