PiCCO原理以及计算过程_精品文档优质PPT.ppt
- 文档编号:15484431
- 上传时间:2022-11-01
- 格式:PPT
- 页数:49
- 大小:3.71MB
PiCCO原理以及计算过程_精品文档优质PPT.ppt
《PiCCO原理以及计算过程_精品文档优质PPT.ppt》由会员分享,可在线阅读,更多相关《PiCCO原理以及计算过程_精品文档优质PPT.ppt(49页珍藏版)》请在冰豆网上搜索。
IntroductiontoPiCCOTechnologyPiCCO技术的介绍1.Principlesoffunction理论知识2.Thermodilution热稀释法3.Pulsecontouranalysis脉搏轮廓分析法4.Contractilityparameters收缩力参数5.Afterloadparameters后负荷参数6.Extravascularlungwater血管外肺水7.Pulmonarypermeability肺通透性指数血流动力学监测血流动力学监测TheoryandPracticePiCCOTechnologyParametersforguidingvolumetherapyIntroductiontothePiCCO-TechnologyCO心排量Volumetricpreload容量负荷EVLW肺水Contractility收缩力DifferentiatedVolumeManagement-static-dynamic-PiCCOTechnologyisacombinationoftranspulmonarythermodilutionandpulsecontouranalysisPiCCO技术是经肺热稀释法和脉搏轮廓分析法的结合PrinciplesofMeasurementLeftHeartRightHeartPulmonaryCirculationLungsBodyCirculationPULSIOCATHPULSIOCATHCVCPULSIOCATHarterialthermodilutioncathetercentralvenousbolusinjectionIntroductiontothePiCCO-TechnologyFunctionBolusinjectionconcentrationchangesovertime(Thermodilutioncurve)Aftercentralvenousinjectionthecoldbolussequentiallypassesthroughthevariousintrathoraciccompartments中心静脉弹丸注射后,冰盐水会通过胸腔内的各个腔室。
@#@Thetemperaturechangeovertimeisregisteredbyasensoratthetipofthearterialcatheter动脉导管尖端的感受器探测到注射液温度的改变。
@#@IntroductiontothePiCCO-TechnologyFunctionLeftheartRightheartLungsRARVLALVPBVEVLWEVLWPrinciplesofMeasurementIntrathoracicCompartments(mixingchambers)IntroductiontothePiCCO-TechnologyFunctionPulmonaryThermalVolume(PTV)肺内肺内热稀稀释容容积IntrathoracicThermalVolume(ITTV)胸腔内热容积胸腔内热容积Totalofmixingchambers所有的混合腔室RARVLALVPBVEVLWEVLWLargestsinglemixingchamber最大的单一混合腔室HaemodynamicMonitoringE.IntroductiontoPiCCOTechnology1.Principlesoffunction2.Thermodilution3.Pulsecontouranalysis4.Contractilityparameters5.Afterloadparameters6.ExtravascularLungWater7.PulmonaryPermeabilityTbxdt(Tb-Ti)xVixKTbInjectiontDD=COTDaTb=BloodtemperatureTi=InjectatetemperatureVi=InjectatevolumeTb.dt=AreaunderthethermodilutioncurveK=Correctionconstant,madeupofspecificweightandspecificheatofbloodandinjectateTheCOiscalculatedbyanalysisofthethermodilutioncurveusingthemodifiedStewart-Hamiltonalgorithm心排量是通过分析热稀释曲线得来的,应用Stewart-Hamilton定律。
@#@CalculationoftheCardiacOutputIntroductiontothePiCCO-TechnologyThermodilutionTheareaunderthethermodilutioncurveisinverselyproportionaltotheCO.热稀释曲线下的面积是与CO呈反比的。
@#@36,537510ThermodilutioncurvesNormalCO:
@#@5.5l/minIntroductiontothePiCCO-TechnologyThermodilution36,53736,537TimelowCO:
@#@1.9l/minHighCO:
@#@19l/minTimeTimeTemperatureTemperatureTemperatureTranspulmonaryvs.PulmonaryArteryThermodilutionLeftheartRightHeartPulmonaryCirculationLungsBodyCirculationPULSIOCATHarterialthermo-dilutioncathetercentralvenousbolusinjectionRARVPALALVAortaTranspulmonaryTD(PiCCO)PulmonaryArteryTD(PAC)Inbothproceduresonlypartoftheinjectedindicatorpassesthethermistor.在这两种方式中只有一部分注射液会通过热敏感受器。
@#@NonethelessthedeterminationofCOiscorrect,asitisnottheamountofthedetectedindicatorbutthedifferenceintemperatureovertimethatisrelevant!
@#@但是CO正确与否的决定性因素,并不是指示剂的量,而是随着时间变化导致的温度变化,这两者相关的。
@#@IntroductiontothePiCCOTechnologyThermodilutionComparisonwiththeFickMethod0,970,680,6237/449SakkaSGetal.,IntensiveCareMed25,1999-/-0,190,219/27McLuckieA.eta.,ActaPaediatr85,19960,960,160,3130/150GdjeOetal.,Chest113(4),19980.980,320,2923/218HolmCetal.,Burns27,20010,930,130,5260/180DellaRoccaGetal.,EurJAnaest14,20020,95-0,040,4117/102FriedmanZetal.,EurJAnaest,20020,950,490,4545/283BindelsAJGHetal.,CritCare4,20000,980,030,1718/54PauliC.etal.,IntensiveCareMed28,200224/120n(Pts/Measurements)0,990,030,24TibbyS.etal.,IntensiveCareMed23,1997rbiasSD(l/min)ComparisonwithPulmonaryArteryThermodilutionValidationoftheTranspulmonaryThermodilutionIntroductiontothePiCCOTechnologyThermodilutionMTt:
@#@MeanTransittimethemeantimerequiredfortheindicatortoreachthedetectionpointDSt:
@#@DownSlopetimetheexponentialdownslopetimeofthethermodilutioncurveRecirculationte-1TbFromthecharacteristicsofthethermodilutioncurveitispossibletodeterminecertaintimeparameters从热稀释曲线的特点来看,它是可以决定某些时间参数的。
@#@ExtendedanalysisofthethermodilutioncurveIntroductiontothePiCCO-TechnologyThermodilutionInjectionInTbMTtDStTb=bloodtemperature;@#@lnTb=logarithmicbloodtemperature;@#@t=timePulmonaryThermalVolumePTV=DstxCOByusingthetimeparametersfromthethermodilutioncurveandtheCOITTVandPTVcanbecalculated通过热稀释曲线的时间参数,可以计算出ITTV和PTV.CalculationofITTVandPTVIntroductiontothePiCCO-TechnologyThermodilutionRecirculationte-1TbInjectionInTbIntrathoracicThermalVolumeITTV=MTtxCOMTtDStPulmonaryThermalVolume(PTV)IntrathoracicThermalVolume(ITTV)CalculationofITTVandPTVEinfhrungindiePiCCO-TechnologieThermodilutionITTV=MTtxCOPTV=DstxCORARVLALVPBVEVLWEVLWGEDVisthedifferencebetweenintrathoracicandpulmonarythermalvolumes.GEDV就是胸腔内热容积和肺内热容积的差值。
@#@GlobalEnd-diastolicVolume(GEDV)VolumetricpreloadparametersGEDVRARVLALVPBVEVLWEVLWITTVGE
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- PiCCO 原理 以及 计算 过程 精品 文档