sponsor & contact us

A. 高雄醫學大學附設醫院麻醉部
T. 07-3121101 #7033、7035
F. 07-3217874
E. 2020annualmeetingtsa@gmail.com
前茂企業股份有限公司-IR332
前茂企業股份有限公司-IR332
個人簡介

現職

臺北榮總一般麻醉科主任
國立陽明大學醫學系部定教授 
國防醫學院醫學系臨床教授

 

個人經歷

國立陽明大學醫學系麻醉學科主任 
臺北榮總麻醉後恢復室主任 
臺北榮總重症醫學部主治醫師 
臺灣麻醉醫學會監事

ProAQT 在麻醉中之應用

 

ProAQT 是一種利用動脈脈搏波形分析演算法來連續地測量血壓、心輸出量趨勢、容積反應和其他衍生數據的monitor,可以用來作為麻醉中輔助診斷的工具,近年來,就侵入式血流動力學監測有效性及安全性的爭議越來越激烈,SwanGanz導管技術創傷大,留置時間短,併發症多。因而無創/微創血流動力學監測的發展越來越引起關注,如間接Fick法重複呼吸技術、食道都普勒超音波監測技術、PiCCO技術等。ProAQT微創血流動力學監測技術(動脈脈搏輪廓分析技術 )也是一種微創方法,與運用SwanGanz導管間歇熱稀釋法比較測定心輸出量及其他血流動力學參數,有不錯的相關性ProAQT微創血流動力學監測技術除了CO外,還能監測SVV。SVV已被認為是對前負荷化反應敏感的指標,與其他傳統監測指標(HR、MAP、CVP、PAOP)相比能更早期、準確地反映前負荷的變化情況,可以讓臨床醫師進行容量管理時替代中心靜脈壓的角色,該儀器還可監測全身血管阻力(SVR)和全身血管阻力指數(SVRI),指導臨床血管活性藥物的應用。dPmx是動脈壓力曲線上最大的斜率(∆Pmax /∆t),可以用來評估左心的收縮力情況。CPI通過壓力(MAP)和流量(CO)組合計算而來,反應左心輸出能力,是預測心源性休克院內死亡率的最佳指數。

 

The Application of ProAQT in Anesthesia

 

ProAQT is a monitor that uses arterial pulse contour analysis algorithms to continuously measure blood pressure, cardiac output, volume response and other derived data. It can be used as an auxiliary diagnostic tool during anesthesia. In recent years, invasive hemodynamic monitoring shows controversy in the effectiveness and safety. The Swan-Ganz catheter is traumatic, of short indwelling time, and with more complications. Therefore, the development of non-invasive/minimally invasive hemodynamic monitors have attracted more attention, such as indirect Fick cardiac output measurement, esophageal Doppler ultrasound technology, PiCCO, etc. ProAQT hemodynamic monitoring system (arterial pulse contour analysis technology) is a minimally invasive method to determine cardiac output (CO) and other hemodynamic parameters and shows good correlation to data from Swan-Ganz catheter using intermittent thermodilution method. In addition to CO, ProAQT also monitor stroke volume variation (SVV). SVV has been considered as a sensitive indicator to present the changes in preload. Compared with other traditional monitors (HR, MAP, CVP, PAOP), it can early and more accurate reflect the changes of preload to replace the role of CVP in managing fluid status for clinicians. The instrument can also calculate the systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI) to guide the use of vasoactive drugs. dPmx is the maximum slope (∆Pmax /∆t) of the arterial pressure curve, which can be used to evaluate the contractile force of left heart. CPI is calculated by the combination of pressure (MAP) and flow (CO), reflecting the left heart output capacity. It is the best index for predicting the in-hospital mortality of cardiogenic shock.