高端监护参数培训_大区.ppt

* * * 生物组织如肌肉、骨骼、脂肪和血液都具有不同的电传导性。在上述生物组织中，血液的电传导性是最强的。因为动脉血流是搏动的，动脉血管壁具有顺应性。由于心室收缩，胸部动脉系统（主要是主动脉）的血流量会产生搏动变化。这种血流量的搏动变化会导致胸部电传导阻抗的变化。胸部电传导阻抗的变化主要是随主动脉血流流速和流量的变化而变化。 心阻抗技术是用来测量电信号通过胸部传导时的阻力或阻抗的。电信号通过胸部传导时总是寻找阻力最小的路径，因为体内血液导电性最强，而胸部的血液主要集中在主动脉，这样，每次心脏搏动时，主动脉的血容量和血流速度都会发生变化，从而导致电信号传导的阻抗或阻力发生相应的变化，应用这些随时间变化的阻抗即可计算出每次心脏搏动的泵血量（即搏出量）。 生物组织如肌肉、骨骼、脂肪和血液都具有不同的电传导性。在上述生物组织中，血液的电传导性是最强的。因为动脉血流是搏动的，动脉血管壁具有顺应性。由于心室收缩，胸部动脉系统（主要是主动脉）的血流量会产生搏动变化。这种血流量的搏动变化会导致胸部电传导阻抗的变化。胸部电传导阻抗的变化主要是随主动脉血流流速和流量的变化而变化。 心阻抗技术是用来测量电信号通过胸部传导时的阻力或阻抗的。电信号通过胸部传导时总是寻找阻力最小的路径，因为体内血液导电性最强，而胸部的血液主要集中在主动脉，这样，每次心脏搏动时，主动脉的血容量和血流速度都会发生变化，从而导致电信号传导的阻抗或阻力发生相应的变化，应用这些随时间变化的阻抗即可计算出每次心脏搏动的泵血量（即搏出量）。 * * * This graph provides the results relating to the absolute accuracy of the BioZ Cardiac Index. The data are plotted with the TD CI values on the X-axis and the BioZ CI values on the Y-axis. As you can see, the data points fall very closely to the line drawn on the graph, indicating strong association. More importantly, the correlation coefficient (r value) was reported as 0.93, which is very good. This means that there was a very strong association between the TD and BioZ CI values. (As a point of reference, perfect correlation is 1.0; so, 0.93 represents a very strong correlation.). Additionally, the Bland Altman Bias and Precision values were reported. This is another statistical tool that is used to evaluate the degree of agreement between results of two procedures. The Bias of 0.07 indicates that the average BioZ value was 0.07 L/min/m2 higher than the average TD value, which is excellent. In other words, if the average TD value was 2.50, the average BioZ value was 2.57 L/min/m2! The precision is similar to standard deviation and the value of 0.40 L/min/m2 is also very good. * * 这些局限性和危险性使得无创方法成为血液动力学监护必然的发展趋势。心阻抗图（Impedance Cardiograghy，简称ICG）提供了足够的性能和安全保证，成为一种成熟而应用广泛的测量技术。 * * * * BIS monitoring is a non-invasive technology. A BIS sensor is placed on your forehead and then connected through a cable