科研之友
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摘要
BACKGROUND: The thermodilution curve assessed by transpulmonary thermodilution is the basis for calculation of global end-diastolic volume index (GEDI) and extravascular lung water index (EVLWI). Until now, it was unclear whether the method is affected by 1-lung ventilation. Therefore, aim of our study was to evaluate the impact of 1-lung ventilation on the thermodilution curve and assessment of GEDI and EVLWI. METHODS: In 23 pigs, mean transit time, down slope time, and difference in blood temperature (T-b) were assessed by transpulmonary thermodilution. Gold standard cardiac output was measured by pulmonary artery flowprobe (PAFP) and used for GEDI(PAFP) and EVLWIPAFP calculations. Measurements were performed during normovolemia during double-lung ventilation (M1), 15 minutes after 1-lung ventilation (M2) and during hypovolemia (blood withdrawal 20 mL/kg) during double-lung ventilation (M3) and again 15 minutes after 1-lung ventilation (M4). RESULTS: Configuration of the thermodilution curve was significantly affected by 1-lung ventilation demonstrated by an increase in T-b and a decrease in mean transit time and down slope time (all P < 0.04) during normovolemia and hypovolemia. GEDI(PAFP) was lower after 1-lung ventilation during normovolemia (M1: 459.9 67.5 mL/m(2); M2: 397.0 +/- 54.8 mL/m(2); P = 0.001) and hypovolemia (M3: 300.6 +/- 40.9 mL/m(2); M4: 275.2 +/- 37.6 mL/m(2); P = 0.03). EVLWIPAFP also decreased after 1-lung ventilation in normovolemia (M1: 9.0 [7.3, 10.1] mL/kg; M2: 7.4 [5.8, 8.3] mL/kg; P = 0.01) and hypovolemia (M3: 7.4 [6.3, 9.7] mL/kg; M4: 5.8 [5.2, 7.4]) mL/kg; P = 0.0009). CONCLUSION: Configuration of the thermodilution curve and therefore assessment of GEDI and EVLWI are significantly affected by 1-lung ventilation.
- 出版日期2013-7
