休克基礎(chǔ)監(jiān)護及治療進(jìn)展下(編輯修改稿)
2024-09-29 09:25 本頁面
【文章內(nèi)容簡介】 lobal Ejection Fraction Comparison of the GEF with the gold standard TEE measured contractility in patients without right heart failure sensitivity 0 0,4 0,6 0,8 0 1 0,2 0,2 0,4 0,6 0,8 1 specifity 22 20 19 18 16 12 8 D FAC, % D GEF, % 5 10 5 20 10 10 20 15 15 10 r=076, p0,0001 n=47 心肌收縮性 來源于經(jīng)肺熱稀釋法的心肌收縮性參數(shù) 2020/9/5 33 PUMCH ? is similar to the GEF ? a parameter of both left and right ventricular contractility CFI = Cardiac Function Index心 臟 功能指數(shù) CI CFI = GEDVI 心肌收縮性 來源于經(jīng)肺熱稀釋法的心肌收縮性參數(shù) 2020/9/5 34 PUMCH ? 心血管狀態(tài)信息的重要 ? 控制容量和血管活性藥物應(yīng)用的重要決定因素 (MAP – CVP) x 80 SVR = CO 后負(fù)荷 SVR = Systemic Vascular Resistance MAP = Mean Arterial Pressure CVP = Central Venous Pressure CO = Cardiac Output 80 = Factor for correction of units 2020/9/5 35 PUMCH ? dPmx 左室功能 ? GEF and CFI 全心功能 ? SVR 心血管狀態(tài)信息的重要 小 結(jié) 2020/9/5 36 PUMCH 血流動力學(xué)監(jiān)測的別樣選擇 來源于 PiCCO 技術(shù)的 EVLW和 PVPI 1. Extravascular Lung Water（EVLW） 2. Pulmonary Permeability (PVPI) 2020/9/5 37 PUMCH ITTV – ITBV = EVLW Extravascular Lung Water (EVLW)的計算 2020/9/5 38 PUMCH Katzenelson et al,Crit Care Med 32 (7), 20xx Sakka et al, Intensive Care Med 26: 180187, 20xx Gravimetry Dye dilution EVLW from the PiCCO technology has been shown to have a good correlation with the measurement of extravascular lung water via the gravimetry and dye dilution reference methods Validation of EVLW n = 209 r = ELWI by gravimetry ELWI by PiCCO R = 0,97 P 0,001 Y = + 0 10 20 30 20 30 40 10 ELWITD (ml/kg) 0 5 10 20 15 25 25 5 0 10 0 20 15 ELWIST (ml/kg) 2020/9/5 39 PUMCH ELWI = 7 ml/kg ELWI = 8 ml/kg ELWI = 14 ml/kg ELWI = 19 ml/kg Extravascular lung water index (ELWI) normal range: 3 – 7 ml/kg EVLW as a quantifier of lung oedema 與 Xray比較，優(yōu)勢 2020/9/5 41 PUMC
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