摘要
目的:明确中心静脉压(CVP)和有创动脉血压(IBP)测量过程中的校零时机及零点位置,为临床诊治提供更科学准确的监测结果。方法:运用液体容器实验模型模拟连续压力监测系统的测压过程,基于流体力学理论并结合血压的生理学及心血管解剖学知识,分析校零及标定CVP和IBP零点位置过程中充液导管系统内压力的组成及影响因素。结果:校零时充液导管系统内的压力由大气压、加压袋压力、墨菲滴管液面与压力传感器的垂直距离(ΔH)水柱重力和导管壁阻力组成,此压力数值为基线0 mmHg(1 mmHg≈0.133 kPa);测压过程中当压力传感器置于容器最高液平面下10 cm水平位置时,不同的导管尖端位置测得的压力均为10 cmH 2O(1 cmH 2O≈0.098 kPa);当压力传感器置于容器最高液平面水平时,测得压力为0 mmHg。 结论:仅在评估到大气压、加压袋压力、ΔH水柱重力和导管壁阻力其中1个或多个条件发生变化时才需要重复校零;测量过程中应随时调整压力传感器于零点位置以消除静水压的影响,确保数值客观、准确。
Objective To figure out the timing of zeroing and the location of the zero line in the central venous pressure(CVP)monitoring and invasive arterial blood pressure(IBP)monitoring,and to provide scientific and accurate data for patients management.Methods The liquid vessel models were used to simulate the pressure measurement process of the continuous pressure monitoring system.Based on the theory of fluid mechanics and the knowledge of blood pressure physiology and cardiovascular anatomy,the composition and influencing factors of the pressure in the fluid-filled catheter system during the zeroing and placing the transducer in the zero line of CVP and IBP,were analyzed.Results The pressure in the liquid-filled catheter system was composed of atmospheric pressure,the pressure of pumping bag,the gravity of the water column(the vertical distance between the liquid level of Murphy's dropper and pressure transducer,ΔH),and the resistance of tube wall.This pressure value is set as a pressure of 0 mmHg(1 mmHg≈0.133 kPa).In the process of pressure measurement,when the pressure transducer was placed at a horizontal position of 10 cm below the highest liquid level of the vessel,the pressure measured at different catheter tip positions was all 10 cmH2O(1 cmH2O≈0.098 kPa);When the pressure transducer was placed at the horizontal position of the highest liquid level of the vessel,the measured pressure is 0 mmHg.Conclusion Zeroing should repeatedly be performed only when one or more conditions(atmospheric pressure,pressure of pumping bag,gravity ofΔH water column and resistance of tube wall)are changed.In the measurement process,the pressure transducer should be placed at the zero line position at any time to eliminate the influence of hydrostatic pressure and to ensure the objective and accurate value.
作者
周晶
左祥荣
刘少华
褚敏娟
田雅丽
Zhou Jing;Zuo Xiangrong;Liu Shaohua;Chu Minjuan;Tian Yali(Department of Intensive Care Unit,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210000,Jiangsu,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2023年第3期316-320,共5页
Chinese Critical Care Medicine
基金
江苏省"333高层次人才培养工程"项目(2022-3-25-045)
江苏省临床重点专科项目(2011-130)。
关键词
中心静脉压
有创动脉血压
校零
零点位置
测量
准确性
Central venous pressure
Invasive arterial blood pressure
Zeroing
Zero line
Monitoring
Accuracy of measurement
