超声心输出量监护仪在重症肺炎患儿心功能评价中的应用

范娟, 陈志颖, 陈芃螈, 陈昌辉

中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (9) : 817-820.

PDF(1216 KB)
HTML
PDF(1216 KB)
HTML
中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (9) : 817-820. DOI: 10.7499/j.issn.1008-8830.2016.09.006
论著·临床研究

超声心输出量监护仪在重症肺炎患儿心功能评价中的应用

  • 范娟, 陈志颖, 陈芃螈, 陈昌辉
作者信息 +

Application of ultrasonic cardiac output monitor in evaluation of cardiac function in children with severe pneumonia

  • FAN Juan, CHEN Zhi-Ying, CHEN Peng-Yuan, CHEN Chang-Hui
Author information +
文章历史 +

摘要

目的 研究便携式超声心输出量监护仪 (ultrasonic cardiac output monitor,USCOM)在重症肺炎患儿的临床应用。方法 应用USCOM分别测量29例重症肺炎患儿 (观察组)及43例轻症肺炎患儿 (对照组)心功能相关指标,将两组结果进行比较分析差异,并比较观察组治疗前后心功能指标变化。结果 观察组较对照组相比心率、心输出量、每搏输出量、速度峰值差异有统计学意义 (P < 0.05),心脏指数、外周血管阻力差异无统计学意义 (P > 0.05)。观察组治疗后心率、心输出量、每搏输出量、速度峰值、心脏指数、外周血管阻力较治疗前改善,差异有统计学意义 (P < 0.05)。结论 应用USCOM可快速、简便、准确、动态了解重症肺炎患儿的心功能状态及患儿整体循环状态,为诊断、治疗及评估病情提供依据,具有很强的实用性。

Abstract

Objective To study the clinical application of ultrasonic cardiac output monitor (USCOM) in evaluation of cardiac function in children with severe pneumonia. Methods Twenty-nine children with severe pneumonia were enrolled in the observation group and forty-three children with common pneumonia were enrolled in the control group. The USCOM was used to measure the cardiac function indices in the two groups. The results were compared between the two groups. The changes in cardiac function indices after treatment were evaluated in the observation group. Results The observation group had a significantly higher heart rate and significantly lower cardiac output, systolic volume, and aortic peak velocity than the control group (P < 0.05). There were no significant differences in cardiac index or systemic vascular resistance between the two groups (P > 0.05). In the observation group, the heart rate, cardiac output, systolic volume, aortic peak velocity, cardiac index, and systemic vascular resistance were significantly improved after treatment (P < 0.05). Conclusions The USCOM is a fast, convenient, and accurate approach for dynamic measurement of cardiac function and overall circulation state in children with severe pneumonia. The USCOM can provide a basis for diagnosis, treatment, and evaluation of the disease, which is quite useful in clinical practice.

关键词

重症肺炎 / 超声心输出量 / 心功能 / 儿童

Key words

Severe pneumonia / Ultrasonic cardiac output monitor / Cardiac function / Child

引用本文

导出引用
范娟, 陈志颖, 陈芃螈, 陈昌辉. 超声心输出量监护仪在重症肺炎患儿心功能评价中的应用[J]. 中国当代儿科杂志. 2016, 18(9): 817-820 https://doi.org/10.7499/j.issn.1008-8830.2016.09.006
FAN Juan, CHEN Zhi-Ying, CHEN Peng-Yuan, CHEN Chang-Hui. Application of ultrasonic cardiac output monitor in evaluation of cardiac function in children with severe pneumonia[J]. Chinese Journal of Contemporary Pediatrics. 2016, 18(9): 817-820 https://doi.org/10.7499/j.issn.1008-8830.2016.09.006

参考文献

[1] Rudan I, O'Brien KL, Nair H, et al. Epidemiology and etiology of childhood pneumonia in 2010:estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries[J]. J Glob Health, 2013, 3(1):010401.
[2] Scott JA, Brooks WA, Peiris JS, et al. Pneumonia research to reduce childhood mortality in the developing world[J]. J Clin Invest, 2008, 118(4):1291-1300.
[3] 李小丽, 叶彩霞, 唐海霞, 等. 彩色双功能超声对婴幼儿重症肺炎的右心功能评价及临床价值[J]. 中外健康文摘, 2013, 10(8):10-11.
[4] 刘继红, 龚小倩, 王芳. 脉冲多普勒Tei指数在评价小儿重症肺炎心功能的研究[J]. 国际医药卫生导报, 2013, 19(21):3274-3277.
[5] Dhanani S, Barrowman NJ, Ward RE, et al. Intra-and interobserver reliability using a noninvasive ultrasound cardiac output monitor in healthy anesthetized children[J]. Paediatr Anaesth, 2011, 21(8):858-864.
[6] Beltramo F, Menteer J, Razavi A, et al. Validation of an Ultrasound Cardiac Output Monitor as a Bedside Tool for Pediatric Patients[J]. Pediatr Cardiol, 2016, 37(1):177-183.
[7] 韩英, 刘涛, 耿荣, 等. 便携式超声心输出量监护仪在肺炎合并心力衰竭患儿心功能状态评价中的意义[J]. 中国小儿急救医学, 2014, 21(5):285-287.
[8] 王卫平, 毛萌. 儿科学[M]. 8版. 北京:人民卫生出版社, 2014:277-278.
[9] He SR, Zhang C, Liu YM, et al. Accuracy of the ultrasonic cardiac output monitor in healthy term neonates during postnatal circulatory adaptation[J]. Chin Med J (Engl), 2011, 124(15):2284-2289.
[10] Kanmaz HG, Sarikabadayi YU, Canpolat E, et al. Effects of red cell transfusion on cardiac output and perfusion index in preterm infants[J]. Early Hum Dev, 2013, 89(9):683-686.
[11] He SR, Sun X, Zhang C, et al. Measurement of systemic oxygen delivery and inotropy in healthy term neonates with the Ultrasonic Cardiac Output Monitor (USCOM)[J]. Early Hum Dev, 2013, 89(5):289-294.
[12] Feldman C, Anderson R. Community-acquired pneumonia:pathogenesis of acute cardiac events and potential adjunctive therapies[J]. Chest, 2015, 148(2):523-532.
[13] Hu D, Liu Y, Tao H, et al. Clinical value of plasma B-type natriuretic peptide assay in pediatric pneumonia accompanied by heart failure[J]. Exp Ther Med, 2015, 10(6):2175-2179.
[14] Gregory SD, Cooney H, Diab S, et al. In vitro evaluation of an ultrasonic cardiac output monitoring (USCOM) device[J]. J Clin Monit Comput, 2016, 30(1):69-75.
[15] Zorko DJ, Choong K, Gilleland J, et al. Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team:a pilot study[J]. PLoS One, 2013, 8(6):e66951.
[16] Chong SW, Peyton PJ. A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM)[J]. Anaesthesia, 2012, 67(11):1266-1271.
[17] Chand R, Mehta Y, Trehan N. Cardiac output estimation with a new Doppler device after off-pump coronary artery bypass surgery[J]. J Cardiothorac Vasc Anesth, 2006, 20(3):315-319.
[18] Wongsirimetheekul T, Khositseth A, Lertbunrian R. Noninvasive cardiac output assessment in critically ill paediatric patients[J]. Acta Cardiol, 2014, 69(2):167-173.
[19] Minneci PC, Kilbaugh TJ, Chandler HK, et al. Factors associated with mortality in pediatric patients requiring extracorporeal life support for severe pneumonia[J]. Pediatr Crit Care Med, 2013, 14(1):e26-e33.
[20] 李援越. 心输出量监测系统在儿童危重症中的应用研究[J]. 中国小儿急救医学, 2012, 19(6):607-609.
[21] Chang AC. Determination of cardiac output in critically ill children:are we any closer to the ideal methodology?[J]. Pediatr Crit Care Med, 2012, 13(1):99.


PDF(1216 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/