Novel Doppler Technique to Assess Systemic Vascular Resistance : The Snuffbox Technique
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概要
- 論文の詳細を見る
Background To explore an alternative to the systemic vascular resistance index (SVRI) for monitoring peripheral circulation in patients in the intensive care unit (ICU), the resistive index (RI) in the upper extremity arteries was measured by using surface Doppler ultrasound. Methods and Results The correlation between RI and vascular resistance was assessed in vitro using a vessel phantom in a Donovan-type mock circulation system. In addition, 15 ICU patients who had undergone open-heart surgery were studied. Mean arterial pressure, central venous pressure and cardiac output were measured 30 times at 10min intervals after patients returned to the ICU following surgery, and the SVRI was calculated from these parameters. At the same time points, 3 parts of the upper extremity arteries (brachial artery in the cubital fossa (BA), radial artery at the wrist (RA), and radial artery at the anatomical snuffbox (SB)) were scanned by Doppler ultrasound, and the resistance index (RI) for each artery region was calculated. In vitro, RI increased with higher vascular resistance, exhibiting a significant correlation (r=0.982, p<0.0001). In vivo, the average incidence angles at the BA and RA were larger than 60°, while that at the SB was only 11.5±10.8°. The overall correlation between SVRI and RI for all patients was not significant for the BA or RA, but was significant for the SB (p<0.0001). In individual patients, the correlation of SVRI with RI at the BA or RA was significant in 3 patients only, whereas significant correlation for the SB was observed in all patients. Doppler waveform analysis at the SB revealed diastolic flow reversal with increased SVRI. Conclusions Measurement at the SB provides an ideal ultrasound incidence angle for the measurement of blood flow velocity. Hence, RI measured in this way may serve as an indicator of peripheral vascular resistance, and may be effective for the evaluation of peripheral circulatory disturbance.
- 社団法人日本循環器学会の論文
- 2005-05-20
著者
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Sueda T
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Sueda Taijiro
広島県厚生農業協同組合連合会廣島総合病院 外科
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Sueda Taijiro
Department Of Surgery Division Of Clinical Medical Science Graduate School Of Biomedical Sciences Hi
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Sueda Taijiro
Deaprtment Of Pediatric Surgery Graduate School Of Biomedical Science Hiroshima University
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Imai Katsuhiko
Department of Cardiovascular Surgery, Hiroshima University Hospital
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Okada Kenji
Department of Cardiovascular Surgery, Hiroshima University Hospital
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Orihashi Kazumasa
Department of Cardiovascular Surgery, Hiroshima University Hospital
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Ban Koji
Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University
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Kochi Kazuhiro
Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University
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Okada K
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Sueda Taijiro
Department Of Cardiovascular Surgery Hiroshima University Graduate School Of Medicine
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Kochi Kazuhiro
Department Of Surgery Division Of Clinical Medical Science Graduate School Of Biomedical Sciences Hi
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Orihashi Kazumasa
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Okada Kenji
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Ban Koji
Department Of Surgery Hiroshima University
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Imai Katsuhiko
Department Of Cardiovascular Surgery Hiroshima University Hospital
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Imai Katsuhiko
Department Of Cardiovascular Surgery Hiroshima University Graduate School Of Medicine
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Santo Takahiro
Department Of Surgery Division Of Clinical Medical Science Graduate School Of Biomedical Sciences Hi
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Okada Kenji
Department Of Applied Chemistry Okayama University Of Science
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Imai Katsuhiko
Department Of Cardiovascular Surgery Hiroshima University School Of Medicine
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Imai Katsuhiko
Department of Cardiovascular Surgery, Hiroshima University School of Medicine
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