摘要
目的：评估生物电抗无创心排量监测（non-invasive cardiac output measurement, NICOM）在儿童中的应用价值。方法选取2012年9月至12月期间收住北京大学第一医院儿科、需进行血流动力学监测者,分别采用 NICOM 及超声心动图法对同一患儿进行心指数（cardiac index,CI）及每搏输出量（stroke volume,SV）的测定。比较两种测定方法结果的一致性。结果共纳入30例患儿,中位年龄7.25岁,NICOM 及超声心动图法测得 CI[中位数（第5,第95百分位数）]分别为3.42（2.28,4.92）L/（min·m^2）和3.51（2.94,4.85）L /（min·m^2）。二者 Spearman 相关系数为0.385（P ＝0.035）,Bland-Altman 分析提示两种方法测值的平均偏倚为-0.22 L/（min·m^2）（P ＝0.051）。NICOM及超声心动图法测得的 SV[中位数（第5,第95百分位数）]分别为36.3（12.6,87.8）ml 和39.4（14.7,86.9）ml。二者 Spearman 相关系数为0.768（P ﹤0.001）,Bland-Altman 分析示两种方法测值平均偏倚为-3.1 ml （P ＝0.176）。结论 NICOM与超声心动图法测得的儿童 CI 及 SV 一致性较好,但在临床常规应用前仍需更多研究证实。
Objective To investigate the value of measurement of cardiac output in children by bio-reactance versus echocardiography.Methods Pediatric patients admitted in pediatric department of Peking University First Hospital from September to December 2012 who needed hemodynamic monitoring were enrolled prospectively.Cardiac index（CI）and stroke volume（SV）were measured by echocardiography and non-invasive cardiac output measurement（NICOM）and compared by Spearman correlation and Bland-Alt-man analysis.Results Thirty patients were included.The median age was 7.25 years.CI[M（P5 ,P95 ）] measured by NICOM and echocardiography were correlated significantly[3.42（2.28,4.92）L /（min·m^2 ） vs.3.51 （2.94,4.85 ）L/（min·m^2 ）,R =0.385,P =0.035 ].Bland-Altman analysis revealed a bias of-0.22 L/（min·m^2 ）（P =0.051 ）,limits of agreement of -1.40 to 0.95 L/（min·m^2 ）.SV[M（P5 ,P95 ）] measured by NICOM and echocardiography were correlated more significantly [36.3 （12.6,87.8 ）ml vs.39.4（14.7,86.9）ml,R =0.768,P ﹤0.001 ].Bland-Altman analysis revealed a bias of -3.1 ml（P =0.176）,limits of agreement of -27.4 to 21.2 ml.Conclusion There is no significant difference between NICOM and echocardiography for the measurement of CI and SV in pediatric patients.Further validation studies need to be conducted before routine clinical use.
出处
《中国小儿急救医学》
CAS
2016年第2期78-81,共4页
Chinese Pediatric Emergency Medicine
关键词
生物电抗
心指数
每搏输出量
儿童
Bioreactance
Cardiac index
Stroke volume
Children
