33 KB127 KB26 KB192920262001Krivec, BojanParežnik, RomanPodbregar, MatejSkale, RafaelVoga, GorazdŽuran, Ivanletnik:70str. I-17-I-21številka:supl. 1ISSN:1318-0347COBISSID:14373849URN:URN:NBN:SI:doc-GTXADHWEslSlovensko zdravniško društvoZdravniški vestnikCardiac outputCatheterization, swan-ganzCritical illnessheartHeart failure, congestivehemodinamikaInfarkt, srčniKateterizacija Swan-GanzovaKongestivno srčno popuščanjeKritična bolezenMyocardial infarctionShock, septicsrcesrčne bolezniSrčni minutni volumenŠok septičniTermodilucijaThermodilutionOcena neprekinjene termodilucijske metode za merjenje minutnega srčnega iztisa| Evaluation of continuous thermodilution method for cardiac output measurement|Background. Continuous monitoring of haemodynamic variables is often necessaryfor detection of rapid changes in critically ill patients. In our patients recently introduced continuous thermodilution technique (CTD) for cardiac output measurement was compared to bolus thermodilution technique (BTD) which is a golden standard method for cardiac output (CO) measurement inintensive care medicine. Methods. Ten critically ill patients were included in a retrospective observational study. Using CTD method cardiac output was measured continuously. BTD measurements using the same equipment were performed intermittently. The data obtained by BTD were compared to those obtained by CTD just before the BTD (CTD-before) and 2-3 minutes after the BTD(CTD-after). The CO values were divided into three groups: all CO values, CO.4.5 L/min, CO<4.5 L/min. The bias (mean difference between values obtained by two methods), standard deviation, 95% confidence limits and relative error were calculated and the linear regression analysis was performed. t-test for pared data was used to compare the biases for CTD-before and CTD-after for an individual group. The p value of less than 0.05 was considered statistically significant. Results. A total of 60 data triplets were obtained. CTD-before ranged from 1.9 L/min to 12.6/min, CTD-after from 2.0 to 13.2 L/min and BTD from 1.9 to 12.0 L/min. For all CO values the bias for CTD-before was 0.13 +- 0.52 L/min (95% confidence limits 1.17-0.91 L/min), relative error was 3.52+-15.20%, linear regression equation was CTD-before + 0.96 x BTD + 0.01 and Pearsons correlation coefficient was 0.95. The values for CTD-after were 0.08 +- 0.46 L/min (1.0-0.84 L/min), 2.22 +- 9.05%, CTD-after =0.98 x BTD + 0.01 and 0.98 respectively. (Abstract truncated at 2000 characters)Izhodišča. Pri zdravljenju kritično bolnih je za zaznavo hitrih sprememb pogosto potreben neprekinjen nadzor hemodinamskih spremenljivk. Pri naših bolnikih smo primerjali novejšo neprekinjeno termodilucijsko metodo za merjenje minutnega srčnega iztisa (CTD) s termodilucijsko metodo z enkratnim odmerkom (BTD), ki velja za "zlati standard" za merjenje minutnega srčnega iztisa (MSI) v intenzivni medicini. Metode. V retrospektivno opazovalno raziskavo smo vključili 10 kritično bolnih. S CTD smo neprekinjeno merili minutni srčni iztis (MSI). Občasno smo z isto opremo izmerili MSI z metodo BTD. Vrednosti MSI, ki smo jih dobili z metodo BTD, smo preimerjali s tistimi,ki smo jih odčitali neposredno pred meritvami BTD (CTD-pred) in 2-3 minute po opravljenih meritvah BTD (CTD-po). Rezultate meritev smo glede na vrednost BTD razdelili v tri skupine: vse vrednosti MSI, MSI>4,5 L/min, MSI<4,5 L/min. Izračunali smo povprečno razliko med rezultati meritev, standardno deviacijo povprečne razlike, 95-odstotni interval zaupanja, relativno napako in napravili linearno regresijsko analizo. S t-testom ya parne podatke smo statistično primerjali povprečno razliko med CTD-pred in BTDs povprečno razliko med CTD-po in BTD za posamezno skupino. Razliko smo šteli za statistično značilno pri vrednosti p<0.05. Rezultati. Skupno smo opravili 60 trojčkov meritve. CTD-pred je znašal od 1,9 do 12,6 L/min, CTD-po od 2,0 do 13,2 L/min in BTD od 1,9 do 12 L/min. Pri vseh vrednostih MSI smo dobili povprečno razliko med CTD-pred in BTD 0,13 +- 0,52 L7min (95-odstotni interval zaupanja 1,17-0,91 L/min), relativno napako 3,25 +- 15,20%, enačbo linearne regresije CTD-pred=0,96xBTD+0.01 in Pearsonov korelacijski koeficient0,95. (Izvleček prekinjen pri 2000 znakih)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo