The Study Of Minimally Invasive/noninvasive Continuous Hemodynamic Monitor In Mechanical Ventilation

Objective: To investigate the agreement between continuous hemodynamic monitor measurements via arterial contour analysis (PICCO), single rebreathing CO2 analysis (NICO) and the clinical gold standard (Swan-Ganz analysis) in ventilated patients with light to seriously low hemodynamic condition; To study the relationship between the . different ventilation modes and hemodynamic monitor by NICO, meantime, to observe the dynamic changes of hemodynamic in the course of ventilation.Methods: 13 ventilated patients with respiratory failure were selected and monitored the hemodynamic values by Swan-Ganz, PiCCO, NICO simultaneously, the corresponsive data were recorded and analysed by linear correlation; Randomized 32 ventilated patients, observed the difference of the condition of hemodynamic when ventilated by bi-level positive airway pressure (BiPAP), pressure supported ventilation (PSV), proportional pressure support (PPS); Observed the change of hemodynamic in 59 ventilated patients from the beginning of the ventilation to the weaning.Results: Linear correlation analysis revealed a good agreement between both PiCCO (Swan-Ganz) and NICO (Swan-Ganz); In the course of low assist ventilation, there' s no significance difference in cardiac function and lung mechanics among the three kinds of ventilation modes inpatients with nearly good cardiac function, but spontaneous ventilation mode (PSV, PPS) can obviously improved the cardiac function, and PPS can improved the cardiac function more significance than PSV in patients with markedly poor cardiac function (P<0.05) ; The CI, CO showed significance ascent and SVR, HR significance descent from the beginning of the ventilation to LAV and LAV to weaning in successful weaning group.Conclusions: PiCCO and NICO can be used in ventilated patients in ICU as a reliable resort to monitor the continuous hemodynamic beside bed, and then to direct a effective treatment strategy; For the minimally effecting on hemodynamics, PPS mode was suitable to the patients with seriously poor cardiac function as a weaning mode; To value the level of cardiac function of patients and its dynamic changes from the beginning of the ventilation to weaning is very significative to the selection of therapeutic strategy, the occasion when LAV begins and successfully wean.