机械通气下早产儿心排血量的准确性研究  

Accuracy of ultrasonic cardiac output measured in preterm infants with mechanical ventilation

作　　者：董慧茹[1,2] 何少茹[2] 郑曼利[2] 陈晓博[2] 钟劲[2] 刘玉梅[2] 孙云霞[2] 

机构地区：[1]南方医科大学研究生学院,广州510515 [2]广东省人民医院新生儿科(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2015年第2期194-198,共5页South China Journal of Cardiovascular Diseases

基　　金：国家"十二五"科技支撑计划项目(2011BAI11B22)

摘　　要：目的评估超声心排血量(cardiac output,CO)监测仪(ultrasound cardiac output monitor,USCOM)用于机械通气下早产儿测量CO的准确性。方法本研究为前瞻性观察性研究,同时使用USCOM和多普勒超声心动图(echocardiography,ECHO)测量40例机械通气下早产儿生后24 h内的CO,采用Bland-Altman及直线相关分析比较两种方法测量结果的一致性。结果 USCOM和ECHO测得的左CO结果分别为(372±89)m L/min和(382±92)m L/min,两者差值平均值和一致性区间为(-10.4±210.1)m L/min,平均百分误差为52.2%。USCOM与ECHO测得的右CO结果分别为(604±143)m L/min和(423±93)m L/min,两者差值平均值和一致性区间为(481.6±301)m L/min,平均百分误差为113%。结论 USCOM测量需要机械通气的早产儿左、右CO时与ECHO一致性较差,可能与生后早期循环过渡及呼吸机高参数有关。因此,机械通气下早产儿心功能的评估仍需进一步研究。Objectives To evaluate the accuracy of ultrasonic cardiac output（CO） measured by ultrasound cardiac output monitor（USCOM） in preterm infants with mechanical ventilation. Methods A prospective and observational study was conducted in 40 preterm infants with mechanical ventilation within 24 hours after birth. Cardiac output was measured by USCOM and echocardiography（ECHO）. Bland-Altman and linear correlation analysis were performed to confirm the consistency. Results Left ventricular outflow（LVO） measured by USCOM and ECHO were（372 ±89）m L / min and（382 ±92） m L / min respectively; while the right ventricular output（RVO） were（604 ±143） m L / min and（423±93） m L / min respectively. Comparison by two techniques for LVO showed the bias and limits of agreement as（-10.4 ±210.1） m L / min, the average percentage error as 52.2%; for RVO, the bias and limits of agreement as（481.6±301） m L / min, the average percentage error as 113%. Conclusions The consistency of USCOM and ECHO in LVO and RVO is poor in preterm infants with mechanical ventilation; which may be associated with early postpartum transition and high ventilation parameters. Cardiac function assessment in critically ill preterm infants with mechanical ventilation still needs further study.

关 键 词：多普勒超声心动图 心排血量 机械通气 早产儿 超声心排血量监测仪 

分 类 号：R540.45[医药卫生—心血管疾病]