摘要
目的评估通过热稀释法测量全心舒张末容量作为心脏前负荷指标的准确性和实用性。方法通过右心漂浮导管和脉搏诱导持续心输出量测量法(PICCO)在20只犬失血性休克模型制作前后,分别给予生理盐水(NS)、贺斯溶液(HES)、高渗盐溶液(HS)以及高渗高张溶液(HSS)对失血性休克模型进行容量复苏,测量容量复苏前后血液动力学,比较全心舒张末容量(GEDV)、中心静脉压(CVP)、肺动脉楔压(PAWP)在判定前负荷中的作用。结果容量复苏前后血液动力学指标有显著变化(P<0·05),全心舒张末容量指数(GEDVI)变化与每搏输出指数(SVI)和心输出量指数(CI)的变化呈正相关。中心静脉压和肺动脉楔压的变化与每搏输出指数(SVI)无关。结论在失血性休克犬模型中,与压力指标(中心静脉压、肺动脉楔压)相比较,全心舒张末容量(GEDV)能够更好地反映心脏前负荷。
Objective To assess the value of the global end - diastolic volume （GEDV） as an indicator of cardiac preload in hemorrhaged shock models of dog. Methods In 20 dogs with hemorrhaged shock, hemodynamic parameters were evaluated by the 2 kinds of thermodilution technique including Swan - Ganz catheter and pulse induced continuous cardiac output （PICCO）, before and after hemorrhaged shock, and after volume resuscitation. The hemorrhaged shock models of dog were resuscitated with NS in a 3 ： 1 relation to removed blood volume; HS,6 mL/kg; HSS,6 mL/kg; and HES as the same as the removed blood volume. To compare the global end- diastolic volume （GEDV） with central venous pressure （CVP）and pulmonary artery wedge pressure （PAWP）, and find the difference of them. Result Volume loading induced a significant （ P 〈 0. 05 ） Changes in GEDV index were correlated with changes in SVI,while changes in CVP and PAWP were not. Conclusion In dog models with hemorrhaged shock,our findings demonstrate that in contrast to CVP,PAWP,GEDV index behaves more accurately as an indicator of cardiac preload.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第5期360-362,共3页
Chinese Journal of Critical Care Medicine
关键词
全心舒张末容量
前负荷
失血性休克
中心静脉压
肺动脉楔压
global end diastolic volume
hemorrhaged shock
preload
central venous pressure
pulmonary artery wedge pressure
