Management of Circulatory and Respiratory Failure Using Less Invasive Hemodynamic Monitoring

摘要: In patients instrumented with a central venous line and thermodilution arterial catheter, the transpulmonary technique — currently available on “PiCCOplus” monitor (Pulsion Medical Systems, Munich, Germany) “CCO” cardiac output module of Philips Systems allows simultaneous assessment valuable cardiovascular dynamic heart-lung-interaction parameters. After injection an ice-cold or room-tempered saline bolus, thermistor in tip catheter is used to measure downstream temperature changes. The then calculated by analysis curve using modified Stewart-Hamilton algorithm. also calculates mean transit time exponential downslope curve. product volume distribution thermal indicator [1]. This distribution, so-called ‘intrathoracic volume’, made up intrathoracic blood (ITBV) extravascular lung water (EVLW) (Fig. 1). ‘pulmonary volume’ [2], which composed pulmonary EVLW Therefore, contained four heart chambers called global end-diastolic (GEDV) easily obtained as difference between [3, 4] ITBV has been shown be quite consistently 25% greater than GEDV [4]. estimated 1.25×GEDV [4]