休克与血流动力学监测课件.ppt

2019/3/24 31 西安交大红会医院 CO 的测量方法－有创 临床应用成熟 ? CO-TDs Thermodilution CO PAC-CO 温度 ( 热 ) 稀释法 ? CO- 染料稀释法 New England Journal of Medicine (1970) 2019/3/24 32 西安交大红会医院 血流动力学监测革命的第一步 ? 1970 年，Ｈ . Ｊ . Ｃ Ｓ wan 和 William Ganz 发明了带套囊的肺动脉漂浮导管 Ｓ wan-Ganz 导管 New England Journal of Medicine (1970) 2019/3/24 33 西安交大红会医院 ＞ 2019/3/24 34 西安交大红会医院 Swan-Ganz 导管 2019/3/24 35 西安交大红会医院 进 步 ? 持续ＣＯ监测 ? 1992 连续 温度稀释法 2019/3/24 36 西安交大红会医院 PAC 的作用 ______ ___ _________ ______ ____ ____ __ ________ ____ ______ ______ __ ____ __ ___ ___________ ________ __ _______ _____________ ______ _ ______ _____ __ __ __ _____________ __ _____ _____ _______________ __ ___ _______ ____ __ __________ ___ ________ ____________ _______ ____ __ ____________ _______ ___ ________ __ _________ ______ _________ ___ ___ ____ _____ ________ _______ __ ________ ________ __ _______ _ ___ ________ ___ ________ ____ ______ ___ __ __ ____ _____ _______________ ___ _______ _____________ __ ________ __________ __________ _______ __ _____________ _____ ? higher 30-day mortality ? higher mean cost of hospital stay ? longer length of stay in the ICU ? significant increase in cardiac complications 1.Connors AF Jr, Speroff T, Dawson NV,et al. (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 276:889 – 897 2 .Mackirdy FL, Howie JC (1997) The relationship between the presence of pulmonary artery catheters and the case mixed adjusted outcome of patients admitted to Scottish ICU ' s. Clin Intensive Care 8:9 – 133 3.Polanczyk CA, Rohde LE, Goldman L,Cook EF,et al(2001) Right heart catheterization and cardiac complications in patie