Respiratory dysfunction following cardiopulmonary bypass: verification of a non-invasive technique to measure shunt fraction
| Autor: | M.M. El-Fiky, David J. Wheatley, Roger Carter, D.P. Taggart, M.C. Stockwell, B.H. Maule |
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| Rok vydání: | 1993 |
| Předmět: |
Pulmonary and Respiratory Medicine
Lung Diseases Male Cardiac output medicine.medical_treatment law.invention law Cardiopulmonary bypass medicine Humans Cardiac Output Lung Aged Cardiopulmonary Bypass business.industry Pulmonary Gas Exchange Pulmonary artery catheter Middle Aged Confidence interval Shunt (medical) medicine.anatomical_structure Respiratory failure Anesthesia Pulmonary shunt Female medicine.symptom business |
| Zdroj: | Respiratory medicine. 87(3) |
| ISSN: | 0954-6111 |
| Popis: | Respiratory dysfunction is a well recognized complication of cardiopulmonary bypass. The size of the pulmonary shunt fraction is the best indicator of respiratory dysfunction but its measurement conventionally requires use of a pulmonary artery catheter to measure mixed venous oxygen content. We compared pulmonary shunt fraction, based on a non-invasive technique using a previously described mathematical model, with shunt fraction measured invasively using a pulmonary artery catheter in 22 patients undergoing elective coronary artery surgery. The mean shunt fraction measured by the invasive technique was 19·6 ± 2·0 (18·8–20·4)% of cardiac output at 24 h (± 1 sd and 90% confidence intervals) and 20·9 ± 2·9 (19·8–22·0)% of cardiac output at 44 h post-surgery. There was good agreement between the two methods of measurement. The mean difference was 0·21 percentage points with 95% confidence interval −0·01 to 0·43. The limits of agreement (−1·17 to 1·59) are small enough to be confident that the non-invasive method can be used to give the same result as that obtained using a pulmonary artery catheter. The values for shunt fractions obtained by the non-invasive technique were 19·7 ± 2·3 (18·8–20·6)% of cardiac output at 24 h and 20·7 ± 2·5 (19·7–21·6)% of cardiac output at 44 h. The non-invasive measurement of the shunt fraction provided us with a simple, practical method for following a further ten patients over an extended period of time where prolonged catheterization is impractical. |
| Databáze: | OpenAIRE |
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