PiCCO原理以及计算过程.ppt

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1、E.IntroductiontoPiCCOTechnologyPrinciplesoffunctionThermodilutionPulsecontouranalysisContractilityparametersAfterloadparametersExtravascularlungwaterPulmonarypermeabilityHaemodynamicMonitoringTheoryandPracticePiCCOTechnologyParametersforguidingvolumetherapyInt

2、roductiontothePiCCO-TechnologyCOVolumetricpreloadEVLWContractilityDifferentiatedVolumeManagementstatic-dynamicPiCCOTechnologyisacombinationoftranspulmonarythermodilutionandpulsecontouranalysisPrinciplesofMeasurementLeftHeartRightHeartPulmonaryCirculationLungsB

3、odyCirculationPULSIOCATHPULSIOCATHCVCPULSIOCATHarterialthermodilutioncathetercentralvenousbolusinjectionIntroductiontothePiCCO-Technology–FunctionBolusinjectionconcentrationchangesovertime(Thermodilutioncurve)Aftercentralvenousinjectionthecoldbolussequentially

4、passesthroughthevariousintrathoraciccompartmentsThetemperaturechangeovertimeisregisteredbyasensoratthetipofthearterialcatheterIntroductiontothePiCCO-Technology–FunctionLeftheartRightheartLungsRARVLALVPBVEVLWEVLWPrinciplesofMeasurementIntrathoracicCompartments(

5、mixingchambers)IntroductiontothePiCCO-Technology–FunctionPulmonaryThermalVolume(PTV)IntrathoracicThermalVolume(ITTV)TotalofmixingchambersRARVLALVPBVEVLWEVLWLargestsinglemixingchamberHaemodynamicMonitoringE.IntroductiontoPiCCOTechnologyPrinciplesoffunctionTherm

6、odilutionPulsecontouranalysisContractilityparametersAfterloadparametersExtravascularLungWaterPulmonaryPermeabilityTbxdt(Tb-Ti)xVixKTbInjectiont∫D=COTDaTb=BloodtemperatureTi=InjectatetemperatureVi=Injectatevolume∫∆Tb.dt=AreaunderthethermodilutioncurveK=Correcti

7、onconstant,madeupofspecificweightandspecificheatofbloodandinjectateTheCOiscalculatedbyanalysisofthethermodilutioncurveusingthemodifiedStewart-HamiltonalgorithmCalculationoftheCardiacOutputIntroductiontothePiCCO-Technology–ThermodilutionTheareaunderthethermodil

8、utioncurveisinverselyproportionaltotheCO.36,537510ThermodilutioncurvesNormalCO:5.5l/minIntroductiontothePiCCO-Technology–Thermodilution36,53736,537TimelowCO:1.9l/minHighCO:19l/minT