• 【用Ocuton眼压计评估眼压计和自我眼压计。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Kóthy P,Nagymihály A,Holló G
    BACKGROUND & AIMS: BACKGROUND:The purpose of the present study was to evaluate the clinical applicability of the Ocuton-A and Ocuton-S applanation tonometers, and to compare their use and accuracy parameters to those of Goldmann applanation tonometry (GAT). MATERIAL/METHODS:In the first study, intraocular pressure (IOP) was measured with an Ocuton-A tonometer, followed by another measurement using GAT in 15 subjects (30 eyes). Ocuton-tonometry was performed on three occasions separated by three-minute intervals. In Study 2 the impact of increased patient familiarity on measurement accuracy using the self-tonometer was investigated in 5 subjects (10 eyes) by comparing two consecutive series of five Ocuton-S measurements. In Study 3 nine trained volunteers measured their own IOP with an Ocuton-S self-tonometer after GAT and Ocuton-A measurements by an experienced investigator. RESULTS:Study 1 showed that the measured IOP value was significantly higher using the Ocuton-A tonometer, compared to values obtained using GAT. In Study 2 we found that increased practice in self-tonometry did not alter measurement accuracy. In Study 3 the difference between IOP readings obtained with the Ocuton-S and Ocuton-A instruments was not significant. CONCLUSIONS:The portable Ocuton-A tonometer may become a useful instrument for IOP measurement by professional workers outside the clinic. Qualified patients are able to use the Ocuton-S self-tonometer reliably even after limited training, and its measurement accuracy is acceptable for IOP monitoring. Both the Ocuton A and S devices consistently overestimate the IOP by approximately 2 mm Hg compared to the corresponding Goldmann readings.
    背景与目标:
  • 【使用动态轮廓眼压计和隐形眼镜眼压计的眼压和眼脉冲幅度。】 复制标题 收藏 收藏
    DOI:10.1186/1471-2415-4-4 复制DOI
    作者列表:Hoffmann EM,Grus FH,Pfeiffer N
    BACKGROUND & AIMS: BACKGROUND:The new Ocular Dynamic Contour Tonometer (DCT), investigational device supplied by SMT (Swiss Microtechnology AG, Switzerland) allows simultaneous recording of intraocular pressure (IOP) and ocular pulse amplitude (OPA). It was the aim of this study to compare the IOP results of this new device with Goldmann tonometry. Furthermore, IOP and OPA measured with the new slitlamp-mounted DCT were compared to the IOP and OPA measured with the hand-held SmartLens,a gonioscopic contact lens tonometer (ODC Ophthalmic Development Company AG, Switzerland). METHODS:Nineteen healthy subjects were included in this study. IOP was determined by three consecutive measurements with each of the DCT, SmartLens, and Goldmann tonometer. Furthermore, OPA was measured three times consecutively by DCT and SmartLens. RESULTS:No difference (P = 0.09) was found between the IOP values by means of DCT (mean: 16.6 mm Hg, median: 15.33 mm Hg, SD: +/- 4.04 mm Hg) and Goldmann tonometry (mean: 16.17 mm Hg, median: 15.33 mm Hg, SD: +/- 4.03 mm Hg). The IOP values of SmartLens (mean: 20.25 mm Hg, median: 19.00 mm Hg, SD: +/- 4.96 mm Hg) were significantly higher (P = 0.0008) both from Goldmann tonometry and DCT. The OPA values of the DCT (mean: 3.08 mm Hg, SD: +/- 0.92 mm Hg) were significantly lower (P = 0.0003) than those obtained by SmartLens (mean: 3.92 mm Hg, SD: +/- 0.83 mm Hg). CONCLUSIONS:DCT was equivalent to Goldmann applanation tonometry in measurement of IOP in a small group of normal subjects. In contrast, SmartLens (contact lens tonometry) gave IOP readings that were significantly higher compared with Goldmann applanation tonometer readings. Both devices, DCT and SmartLens provide the measurement of OPA which could be helpful e.g. for the management of glaucoma.
    背景与目标:
  • 【圆锥角膜和正常眼睛中Goldmann,眼反应分析仪,Pascal和TonoPen XL眼压计的准确性。】 复制标题 收藏 收藏
    DOI:10.1136/bjo.2007.136473 复制DOI
    作者列表:Mollan SP,Wolffsohn JS,Nessim M,Laiquzzaman M,Sivakumar S,Hartley S,Shah S
    BACKGROUND & AIMS: AIM:The aim of this study was to evaluate the practicality and accuracy of tonometers used in routine clinical practice for established keratoconus (KC). METHODS:This was a prospective study of 118 normal and 76 keratoconic eyes where intraocular pressure (IOP) was measured in random order using the Goldman applanation tonometer (GAT), Pascal dynamic contour tonometer (DCT), Reichert ocular response analyser (ORA) and TonoPen XL tonometer. Corneal hysteresis (CH) and corneal resistance factor (CRF), as calculated by the ORA, were recorded. Central corneal thickness (CCT) was measured using an ultrasound pachymeter. RESULTS:The difference in IOP values between instruments was highly significant in both study groups (p<0.001). All other IOP measures were significantly higher than those for GAT, except for the Goldmann-correlated IOP (average of the two applanation pressure points) (IOPg) as measured by ORA in the control group and the CH-corrected IOP (corneal-compensated IOP value) (IOPcc) measures in the KC group. CCT, CH and CRF were significantly less in the KC group (p<0.001). Apart from the DCT, all techniques tended to measure IOP higher in eyes with thicker corneas. CONCLUSION:The DCT and the ORA are currently the most appropriate tonometers to use in KC for the measurement of IOPcc. Corneal factors such as CH and CRT may be of more importance than CCT in causing inaccuracies in applanation tonometry techniques.
    背景与目标:
  • 【胃黏膜中部分二氧化碳张力的眼压计: 使用盐水,缓冲液,胃液或空气。】 复制标题 收藏 收藏
    DOI:10.1186/cc694 复制DOI
    作者列表:Groeneveld AJ
    BACKGROUND & AIMS: :Tonometry of gastric mucosal partial carbon dioxide tension (PCO2) has been forwarded as a clinically applicable tool to monitor regional perfusion adequacy during circulatory failure. The technique is still not used widely, partly because of methodological problems. Current measurement principles are reviewed, with help of the report on PCO2 measurements in gastric juice and tonometer in this issue.
    背景与目标: : 胃粘膜部分二氧化碳张力 (PCO2) 的眼压计已被转发为临床适用的工具,用于监测循环衰竭期间的区域灌注充分性。该技术仍未得到广泛使用,部分原因是方法上的问题。在本期有关胃液和眼压计中PCO2测量的报告的帮助下,回顾了当前的测量原理。
  • 【视网膜神经纤维层厚度分布与CorvisST眼压计之间的关系测量了年轻健康受试者的生物力学特性。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-00345-y 复制DOI
    作者列表:Matsuura M,Murata H,Nakakura S,Nakao Y,Yamashita T,Hirasawa K,Fujino Y,Kiuchi Y,Asaoka R
    BACKGROUND & AIMS: :We previously reported that a shallow circumpapillary retinal nerve fiber layer (cpRNFL) peak angle as measured by optical coherence tomography (OCT) suggests the temporal retina is stretched around the optic disc from the papillo-macular bundle (Yamashita T et al. Investigative Ophthalmol Vis Sci 2013). The purpose of the current study was to investigate the relationship between CorvisST tonometry (CST) corneal measurements, axial length (AL) and the change in OCT-measured cpRNFL peak angle, in young healthy subjects. OCT and CST measurements were carried out in 97 eyes of 97 young healthy volunteers. The relationship between cpRNFL peak angle and 12 CST parameters, adjusted for AL, was investigated using linear modelling. The mean ± standard deviation cpRNFL peak angle of the 97 healthy volunteers was 130.6 ± 25.4 (range: 77.8 to 207.0) degrees. The optimal linear model to explain cpRNFL peak angle (chosen from 216 different models) included three CST variables related to the speed and size of energy absorption (namely, A1 time, A1 length and A2 time), in addition to AL. In eyes with longer AL and shorter energy absorption in CST measurement, temporal retina is stretched around the optic disc from the papillo-macular bundle, as suggested by a shallow cpRNFL peak angle.
    背景与目标: : 我们以前报道过,通过光学相干断层扫描 (OCT) 测量的浅乳头周围视网膜神经纤维层 (cpRNFL) 峰值角度表明颞视网膜从乳头-黄斑束在视盘周围拉伸 (Yamashita T等人。调查眼科Vis Sci 2013)。本研究的目的是研究年轻健康受试者中CorvisST眼压计 (CST) 角膜测量,轴向长度 (AL) 与OCT测量的cpRNFL峰值角变化之间的关系。在97名年轻健康志愿者的97只眼睛中进行了OCT和CST测量。使用线性模型研究了针对AL调整的cpRNFL峰值角与12个CST参数之间的关系。97名健康志愿者的平均   ±  标准偏差cpRNFL峰值角度为130.6   ±   25.4 (范围: 77.8 ~ 207.0) 度。解释cpRNFL峰值角的最优线性模型 (选自216个不同的模型) 除了AL之外,还包括三个与能量吸收的速度和大小 (即A1时间、A1长度和A2时间) 有关的CST变量。在CST测量中AL较长且能量吸收较短的眼睛中,颞视网膜从乳头-黄斑束在视盘周围拉伸,如浅的cpRNFL峰角所示。
  • 【我们能到多低?汤姆森瞪羚 (Gazella thomsoni) 的眼压计。】 复制标题 收藏 收藏
    DOI:10.1097/00061198-200004000-00011 复制DOI
    作者列表:Ofri R,Horowitz IH,Kass PH
    BACKGROUND & AIMS: PURPOSE:To establish a normal reference range of intraocular pressure estimates in Thomson gazelles (Gazella thomsoni). MATERIALS AND METHODS:Applanation tonometry was conducted in 22 eyes of 11 gazelles anesthetized for transportation purposes with a mixture of etorphine hydrochloride and acepromazine maleate. Five sequential readings using a Tono-Pen XL (Mentor Ophthalmics, Inc., Norwell, MA) were obtained from each eye. Results were analyzed for the effect of age, weight, gender, side, and replicate readings and were compared with estimates in other species. RESULTS:Mean (+/- standard deviation) intraocular pressure estimate in 22 eyes of 11 gazelles was 7.6 +/- 1.6 mm Hg. None of the variables tested had a significant effect on the results. CONCLUSIONS:To date, the intraocular pressure estimates in the Thomson gazelle are the lowest reported in any species.
    背景与目标:
  • 【有意识的条件小鼠的回弹眼压法避免了麻醉对眼内压的急性和深刻影响。】 复制标题 收藏 收藏
    DOI:10.1089/jop.2007.0114 复制DOI
    作者列表:Johnson TV,Fan S,Toris CB
    BACKGROUND & AIMS: AIMS:The aims of this study were to evaluate the accuracy, repeatability, and safety of multiple intraocular pressure (IOP) measurements by a commercially available rebound tonometer in conscious, conditioned mice, and to characterize the acute and profound effects of anesthesia on IOP in mice. METHODS:To test the accuracy of the tonometer, IOPs of CD-1 mice under ketamine/xylazine anesthesia were experimentally set and monitored with a water manometer/transducer system following transcorneal cannulation while simultaneously performing tonometry. The long- and short-term repeatability of the tonometer was tested in conscious, restrained mice, as measurements were taken once-daily in the afternoon for 4 consecutive days. On day 5, IOPs were measured in the same mice once every 4 min for 32 min. On 2 separate days, mice were administered ketamine/xylazine or 2,2,2-tribromoethanol anesthesia, in a crossover design, and IOPs were measured once every 2 min for 32 min. Rebound tonometry was performed in conscious mice before and 1 hour after 1 drop of timolol maleate (10 microL of 0.5%) application to 1 eye. RESULTS:IOP measurements by rebound tonometry correlated well with manometry for pressures between 8 and 38 mmHg (y = 0.98x - 0.32, R(2) = 0.94; P < 0.001). The average tonometric IOP was invariant over 4 days (range, 11.7-13.2 mmHg). IOPs dropped significantly ( P < or = 0.05) within 6 min (ketamine/xylazine) or 10 min (2,2,2-tribromoethanol) postadministration of anesthesia but not with conscious restraint. Timolol significantly (P < 0.001) lowered IOP from 12.8 +/- 0.3 (mean +/- standard error of the mean) to 10.1 +/- 0.6 mmHg, as measured by the tonometer. CONCLUSIONS:Rebound tonometry can be used to obtain accurate IOP measurements in conscious, restrained mice while avoiding the rapid and profound ocular hypotensive effects of general anesthesia. Small changes in IOP with an aqueous-flow suppressant are readily detectable with conscious restraint that may be missed with chemical restraint.
    背景与目标:
  • 【一般实践中的眼压计-其在原发性开角型青光眼的早期检测中的应用。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:König HL
    BACKGROUND & AIMS: The intra-ocular pressure of 1078 general practice patients aged over 45 years was measured with the Schiötz tonometer. Primary open-angle glaucoma was found in 29 patients (2.7%) and ocular hypertension in 40 (3.7%). The technique of using the tonometer is described and a plea is made for general practitioners to make more use of it in screening their patients for glaucoma.

    背景与目标: 用schi ö tz眼压计测量了1078名年龄在45岁以上的全科患者的眼内压。原发性开角型青光眼29例 (2.7%),高眼压40例 (3.7%)。描述了使用眼压计的技术,并呼吁全科医生更多地利用它来筛查青光眼患者。
  • 【儿童的正常眼压: Perkins压平眼压计和气动眼压计的比较研究。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Jaafar MS,Kazi GA
    BACKGROUND & AIMS: We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 5 years of age and 12 normal, volunteer adults with the Perkins hand-held applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). Neither sedation, general anesthesia, nor lid specula were used. We confirmed others' findings that the normal IOP, measured in the supine position with the Perkins, is lower in infants and young children (mean = 5.89 mm Hg) than in adults (mean = 13.21 mm Hg; P < .0001). On the other hand, with the Pneuma, the supine pediatric IOP (mean = 14.76 mm Hg) was not significantly different from the adult sitting IOP (mean = 14.42 mm Hg; P = .497). Regression analysis suggests that children and adult Perkins IOP may become equal at around age 12 years.

    背景与目标: 我们使用Perkins手持式压平眼压计 (Perkins) 和Digilab气动眼压计 (Pneuma) 测量了50名5岁以下正常,合作,清醒的儿童和12名正常的志愿者成年人的眼压 (IOP)。既不使用镇静,全身麻醉也不使用盖子。我们证实了其他人的发现,即在Perkins仰卧位测量的正常IOP在婴儿和幼儿 (平均 = 5.89毫米Hg) 中比成人 (平均 = 13.21毫米Hg; P < .0001) 低。另一方面,对于肺炎,仰卧小儿IOP (平均 = 14.76毫米Hg) 与成人坐位IOP (平均 = 14.42毫米Hg; P = .497) 没有显着差异。回归分析表明,儿童和成年Perkins IOP可能在12岁左右变得平等。
  • 【比较从血压计,欧姆龙HEM-9000AI和颈动脉压平眼压计获得的中心压力估计值。】 复制标题 收藏 收藏
    DOI:10.1097/HJH.0b013e328346a3bc 复制DOI
    作者列表:Kips JG,Schutte AE,Vermeersch SJ,Huisman HW,Van Rooyen JM,Glyn MC,Fourie CM,Malan L,Schutte R,Van Bortel LM,Segers P
    BACKGROUND & AIMS: BACKGROUND:The Omron HEM-9000AI is the first automated tonometer to provide an estimate of central SBP (cSBP), which is considered to be more predictive of cardiovascular events than brachial pressure. However, considerable differences between the cSBP estimate of Omron and that of SphygmoCor have been reported, but not explained. This study assesses the sources of differences between both cSBP estimates and provides a handle on which estimate is closest to reality. METHOD:For this purpose, aortic cSBP derived from calibrated carotid SBP was used as device- and algorithm-independent reference. Radial, brachial and carotid applanation tonometry were performed in 143 black South Africans, aged 39-91 years. Each individual was measured with an Omron HEM-9000AI and a SphygmoCor. RESULTS:When using both devices as advocated by their manufacturers, the corresponding cSBP estimates correlated strongly (r = 0.99, P < 0.001), but the Omron estimate was 18.8 (4.3) mmHg higher than the SphygmoCor estimate. Aortic SBP was in between both estimates: 11.7 (5.5) mmHg lower than cSBP-Omron and 7.1 (5.0) mmHg higher than cSBP-SphygmoCor. Alternative calibration of the radial SphygmoCor-curves with radial instead of brachial pressures yielded a cSBP that was 3.0 (4.2) mmHg lower than aortic SBP. The shape of the recorded pressure waves was similar in both devices: less than 5% of the observed cSBP difference was caused by differences in wave shape. CONCLUSION:The results from this study demonstrate that the considerable difference between the central pressure estimates of Omron HEM-9000AI and SphygmoCor is due to algorithm differences, and suggest that the overestimation by Omron HEM-9000AI is larger than the underestimation by SphygmoCor.
    背景与目标:
  • 【颈动脉内膜中层厚度与外周动脉眼压计之间的不一致相关性: 巴西成人健康纵向研究 (ELSA-Brasil)。】 复制标题 收藏 收藏
    DOI:10.1097/MD.0000000000001403 复制DOI
    作者列表:Lemos SP,Passos VMA,Brant LCC,Bensenor IJM,Ribeiro ALP,Barreto SM
    BACKGROUND & AIMS: :To estimate the association between 2 markers for atherosclerosis, measurements of carotid artery intima-media thickness (IMT) and of peripheral arterial tonometry (PAT), and to evaluate the role of traditional cardiovascular risk factors in this association.We applied the 2 diagnostic tests to 588 participants from the ELSA-Brazil longitudinal study cohort. The PAT measurements, obtained with the EndoPAT2000, were the reactive hyperemia index (RHI), the Framingham RHI (F-RHI), and the mean basal pulse amplitude (BPA). We used the mean of the mean scores of carotid IMT of the distal layers of the left and right common carotids obtained by ultrasonography after 3 cardiac cycles. We used linear regression and the Spearman correlation coefficient to test the relationship between the 2 markers, and multiple linear regressions to exam the relationship between the RHI/F-RHI scores and the mean BPA and IMT scores after adjusting for cardiovascular risk factors.In the multivariate analysis, RHI (but not F-RHI) was positively correlated with the mean of the means of the IMT values after adjusting for sex and risk factors connected with both measures (β = 0.05, P = 0.02). Mean BPA did not remain significantly associated with IMT after adjusting for common risk factors.We found that the higher the IMT (or the worse the IMT), the higher the RHI (or the better the endothelial function). F-RHI was not associated with IMT. These 2 results are against the direction that one would expect and may imply that digital endothelial function (RHI and F-RHI) and IMT correspond to distinct and independent stages of the complex atherosclerosis process and represent different pathways in the disease's progression. Therefore, IMT and PAT measures may be considered complementary and not interchangeable.
    背景与目标: : 为了评估动脉粥样硬化的2种标志物,颈动脉内膜中层厚度 (IMT) 的测量和周围动脉眼压计 (PAT) 之间的关联,为了评估传统心血管危险因素在这一关联中的作用,我们对来自ELSA-巴西纵向研究队列的588名参与者进行了2项诊断测试。使用EndoPAT2000获得的PAT测量值是反应性充血指数 (RHI),弗雷明汉RHI (f-rhi) 和平均基础脉冲幅度 (BPA)。我们使用了3个心动周期后通过超声检查获得的左右普通颈动脉远端颈动脉IMT平均得分的平均值。我们使用线性回归和Spearman相关系数来检验2个标志物之间的关系,并使用多元线性回归来检验校正心血管危险因素后RHI/F-RHI评分与平均BPA和IMT评分之间的关系。在多变量分析中,RHI (而非f-rhi) 在调整了与两种措施相关的性别和危险因素后,与IMT值的平均值呈正相关 (β   =   0.05,p   =   0.02)。在调整常见危险因素后,平均BPA与IMT没有显著相关。我们发现IMT越高 (或IMT越差),RHI越高 (或内皮功能越好)。F-rhi与IMT无关。这两个结果违背了人们期望的方向,并可能暗示数字内皮功能 (RHI和f-rhi) 和IMT对应于复杂动脉粥样硬化过程的不同和独立的阶段,并代表了疾病进展的不同途径。因此,IMT和PAT措施可能被认为是互补的,不可互换。
  • 【使用静态,动态和非接触式眼压计进行LASIK术后角膜生物力学和眼内压的变化。】 复制标题 收藏 收藏
    DOI:10.1016/j.ajo.2006.09.036 复制DOI
    作者列表:Pepose JS,Feigenbaum SK,Qazi MA,Sanderson JP,Roberts CJ
    BACKGROUND & AIMS: PURPOSE:To compare the preoperative and postoperative measurement of corneal biomechanical properties and intraocular pressure (IOP) using Goldmann applanation tonometry (GAT), the ocular response analyzer (ORA), and the Pascal dynamic contour tonometer (PDCT) in eyes undergoing myopic laser in situ keratomileusis (LASIK). DESIGN:Prospective, nonrandomized clinical trial. METHODS:IOP was measured in 66 myopic eyes before and after LASIK by GAT, ORA, and PDCT in a randomized sequence. Metrics of corneal biomechanical properties (corneal hysteresis [CH], corneal resistance factor [CRF], and ocular pulse amplitude [OPA]) were recorded. RESULTS:After LASIK, there was a reduction in mean corneal pachymetry of 90.2 mum and in IOP measurements with GAT (Delta = -1.8 +/- 2.8 mm Hg; P < .01), ORA-Goldmann (Delta = -4.6 +/- 2.8 mm Hg, P < .01), and ORA-corneal compensated (Delta - 2.1 +/- 2.6 mm Hg; P < .05). However, there was no statistically significant difference between preoperative and postoperative IOP measurements taken by PDCT (Delta = -0.5 +/- 2.6 mm Hg). Postoperatively, CRF decreased by 28.6% (P < .01), CH by 16.2% (P < .01), and OPA by 1.8% (P = .32). CONCLUSIONS:Measurement of IOP with PDCT appears to be relatively immune to changes in corneal biomechanics and pachymetry after LASIK, in comparison to GAT and ORA measures of IOP. PDCT and ORA both showed statistically lower variation in measurement than GAT. LASIK produced a marked decline in CH and CRF, which may reflect respective changes in the viscous and elastic qualities of the post-LASIK cornea. In contrast, there was no statistical change in OPA.
    背景与目标:
  • 【评估新的原型水凝胶CO( 2) 传感器; 与空气眼压计的比较。】 复制标题 收藏 收藏
    DOI:10.1007/s10877-006-9060-x 复制DOI
    作者列表:ter Steege RW,Herber S,Olthuis W,Bergveld P,van den Berg A,Kolkman JJ
    BACKGROUND & AIMS: OBJECTIVE:Gastrointestinal ischemia is always accompanied by an increased luminal CO(2). Currently, air tonometry is used to measure luminal CO(2). To improve the response time a new sensor was developed, enabling continuous CO(2) measurement. It consists of a pH-sensitive hydrogel which swells and shrinks in response to luminal CO(2), which is measured by the pressure sensor. We evaluated the potential clinical value of the sensor during an in vitro and in vivo study. METHODS:The response time to immediate, and stepwise change in pCO(2) was determined between 5 and 15 kPa, as well as temperature sensitivity between 25 and 40 degrees C at two pCO(2) levels. Three sensors were compared to air tonometry (Tonocap) in healthy volunteers using a stepwise incremental exercise test, followed by a period of hyperventilation and an artificial CO(2)-peak. RESULTS:The in vitro response time to CO(2) increase and decrease was mean 5.9 and 6.6 min. The bias, precision and reproducibility were +5%, 3% and 2%, resp. Increase of 1 degrees C at constant pCO(2) decreased sensor signal by 8%. In vivo tests: The relation with the Tonocap was poor during the exercise test. The response time of the sensor was 3 min during hyperventilation and the CO(2) peak. CONCLUSION:The hydrogel carbon dioxide sensor enabled fast and accurate pCO(2) measurement in a controlled environment but is very temperature dependent. The current prototype hydrogel sensor is still too unstable for clinical use, and should therefore be improved.
    背景与目标:
  • 【胃压计和直接腹内压监测在腹腔室综合征中的作用。】 复制标题 收藏 收藏
    DOI:10.1053/jpsu.2002.30257 复制DOI
    作者列表:Engum SA,Kogon B,Jensen E,Isch J,Balanoff C,Grosfeld JL
    BACKGROUND & AIMS: BACKGROUND/PURPOSE:Abdominal compartment syndrome (ACS) may complicate abdominal closure in patients with abdominal wall defects, abdominal trauma, intraperitoneal bleeding, and infection. Increased intraabdominal pressure (IAP) leads to respiratory compromise, organ hypoperfusion, and a high mortality rate. This study evaluates the efficacy of continuous direct monitoring of IAP and gastric tissue pH in detecting impending ACS.

    METHODS:Ten mongrel puppies weighing 2.8 to 6.4 kg underwent general endotracheal anesthesia, placement of an intraabdominal inflatable balloon to simulate ACS and a Swan-Ganz catheter to measure direct IAP. A gastric tonometer, nasogastric tube, foley catheter, and arterial catheter also were inserted. Half-hourly inflation's of the intraabdominal balloon were used to simulate the development of ACS. Direct intraabdominal (IAP), gastric (GP), bladder (BP), and peak airway pressures (PAP) were measured. Gastric tonometry fluid and arterial blood gas levels were obtained during inflation, and the gastric tissue pH level was calculated. Data were statistically analyzed using Pearson's correlation coefficients.

    RESULTS:Baseline pressures were 2 to 5 cm H(2)O in the stomach and bladder catheters, 1 to 3 mm Hg in the intraabdominal catheter, and correlated with a gastric tissue pH level of 7.4. Significantly high correlation coefficients (cc) were observed between IAP versus BP (cc, 0.77; P <.002). IAP versus GP (cc, 0.79; P <.002) and IAP versus PAP (c, 0.83; P <.0004). A high negative correlation coefficient was noted between gastric pH and IAP (cc, 0.61; P <.026). The pH level dropped to 7.0 with BP and GP of 20 cm H(2)O and IAP of 10 mm Hg, to 6.8 at 30 cm H(2)O and 20 mm Hg, and 6.5 at 40 cm H(2)O and 30 mm Hg, respectively. However, correlation coefficients between gastric tissue pH and BP, GP, or PAP were not significant.

    CONCLUSIONS:These data suggest that continuous direct intraabdominal pressure monitoring is a simple and effective method that correlates well with indirect bladder or gastric pressure measurement. Changes in gastric tissue pH in association with increased intraabdominal pressure may be an early indicator of impending abdominal compartment syndrome. These observations indicate that these techniques may be more sensitive than current methods of indirect measurement, which may be associated with delayed recognition of ACS.

    背景与目标: 背景/目的 : 腹部室室综合征 (ACS) 可能使腹壁缺损,腹部创伤,腹膜内出血和感染的患者的腹部闭合复杂化。腹内压力 (IAP) 升高会导致呼吸系统损害,器官灌注不足和高死亡率。这项研究评估了连续直接监测IAP和胃组织ph值在检测即将发生的ACS中的功效。
    方法 : 十只体重2.8至6.4千克的杂种幼犬接受了全身气管内麻醉,放置腹腔内可充气球囊以模拟ACS,放置Swan-Ganz导管以测量直接IAP。还插入了胃眼压计,鼻胃管,foley导管和动脉导管。腹腔球囊的半小时充气用于模拟ACS的发展。测量直接腹腔内 (IAP),胃 (GP),膀胱 (BP) 和气道峰值压力 (PAP)。在充气过程中获得胃眼压计液和动脉血气水平,并计算胃组织pH水平。使用Pearson相关系数对数据进行统计学分析。
    结果 : 胃和膀胱导管中的基线压力为2至5厘米H(2)O,腹腔导管中的1至3毫米Hg,并且与7.4的胃组织pH水平相关。在IAP与BP之间观察到显着的高相关系数 (cc) (cc,0.77; P <.002)。IAP与GP (cc,0.79; P <.002) 和IAP与PAP (c,0.83; P <.0004)。胃pH与IAP之间存在较高的负相关系数 (cc,0.61; P <.026)。pH水平下降至7.0,BP和GP为20厘米H(2)O,IAP为10毫米Hg,6.8在30厘米H(2)O和20毫米Hg,6.5在40厘米H(2)O和30毫米Hg,分别。但是,胃组织pH与BP,GP或PAP之间的相关系数并不显着。
    结论 : 这些数据表明,连续的直接腹内压监测是一种简单而有效的方法,与间接膀胱或胃压测量密切相关。胃组织ph值的变化与腹内压力升高有关,可能是即将发生腹腔室综合征的早期指标。这些观察结果表明,这些技术可能比当前的间接测量方法更敏感,这可能与ACS的延迟识别有关。
  • 【在控制性低血压中通过动脉眼压计测量血压。】 复制标题 收藏 收藏
    DOI:10.1213/00000539-199107000-00011 复制DOI
    作者列表:Kemmotsu O,Ueda M,Otsuka H,Yamamura T,Okamura A,Ishikawa T,Winter DC,Eckerle JS
    BACKGROUND & AIMS: :A newly developed arterial tonometer enabled us to measure the blood pressure waveforms in addition to determining systolic and diastolic pressures noninvasively and continuously. Twenty-eight adult patients undergoing orthopedic surgery under controlled hypotension were studied. Systolic blood pressure was reduced to two-thirds of baseline values with an infusion of nitroglycerin during nitrous oxide/enflurane anesthesia. Intraarterial blood pressures were simultaneously measured in either the right or the left radial artery with a cannula and a Gould P23XL calibrated transducer; tonometric monitoring was performed on the contralateral radial artery using a Colin CBM-3000 instrument. The outputs of the two blood pressure measurement instruments were recorded for later data analysis. The shape of the tonometric pressure waveform was nearly identical to the waveform recorded intraarterially even during controlled hypotension. Regression analyses of 2039 paired tonometric and intraarterial blood pressure values during the hypotensive period showed good correlations (r = 0.78 for systolic, r = 0.81 for mean, and r = 0.70 for diastolic pressures). The accuracy of systolic, mean, and diastolic readings was from 4 to 7 mm Hg with negligible bias and did not differ significantly among six systolic, four mean, and four diastolic pressure groups. Our results indicate that arterial tonometry can provide accurate, reliable, and real-time monitoring of blood pressure even during controlled hypotension.
    背景与目标: : 新开发的动脉眼压计使我们能够测量血压波形,此外还可以无创,连续地确定收缩压和舒张压。研究了28例在控制性低血压下接受骨科手术的成年患者。在一氧化二氮/恩氟烷麻醉期间输注硝酸甘油使收缩压降低至基线值的3分之2。使用套管和Gould P23XL校准的换能器同时测量右或左radial动脉的动脉内血压; 使用Colin CBM-3000仪器对对侧radial动脉进行眼压监测。记录了两种血压测量仪器的输出,以进行以后的数据分析。即使在控制性低血压期间,眼压波形的形状也几乎与动脉内记录的波形相同。2039年在低血压期间成对的眼压和动脉内血压值进行的回归分析显示出良好的相关性 (收缩压r = 0.78,平均值r = 0.81,舒张压r = 0.70)。收缩压,平均值和舒张压读数的准确性为4至7毫米Hg,偏倚可忽略不计,并且在六个收缩压,四个平均值和四个舒张压组中没有显着差异。我们的结果表明,即使在控制性低血压期间,动脉眼压计也可以提供准确,可靠和实时的血压监测。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录