SSCGCVP CVP SSCG surviving sepsis campaign guideline EGDT

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背景② SSCGはCVPを指標とした初期輸液を推奨している CVPは血管内容量を適切に反映しない可能性がある SSCG, surviving sepsis campaign guideline; EGDT, early goal directed therapy; CVP,

背景② SSCGはCVPを指標とした初期輸液を推奨している CVPは血管内容量を適切に反映しない可能性がある SSCG, surviving sepsis campaign guideline; EGDT, early goal directed therapy; CVP, central vein pressure

経肺熱希釈法 （Trans. Pulmonary Thermo. Dilution method : TPTD） CV catheter 肺循環 冷却した 生理食塩水 TPTD

経肺熱希釈法 （Trans. Pulmonary Thermo. Dilution method : TPTD） CV catheter 肺循環 冷却した 生理食塩水 TPTD catheter 大腿動脈に留置 体循環 Blood temperature Bolus cold saline Thermodilution curve 心臓拡張末期容量 Global End-diastolic Volume (GEDV) Time

Thermodilution Curve 血液温度 生食 投与 脱水 溢水 時間 胸腔内血液容量 Intrathoracic Blood Volume (ITBV) 心臓拡張末期容量

Thermodilution Curve 血液温度 生食 投与 脱水 溢水 時間 胸腔内血液容量 Intrathoracic Blood Volume (ITBV) 心臓拡張末期容量 Global End-diastolic Volume (GEDV) 肺血管内容量 Pulmonary Blood Volume (PBV) 肺血管外水分量 Extravascular Lung Water (EVLW)

Pi. CCO 2 ® Pulsion Medical Systems, Germany EV 1000 ® Edwards Lifesciences, USA

Pi. CCO 2 ® Pulsion Medical Systems, Germany EV 1000 ® Edwards Lifesciences, USA

結果：backgrounds 　 TPTD群 (n = 20) CVP群 (n = 19) P値 年齢 70 (15)

結果：backgrounds 　 TPTD群 (n = 20) CVP群 (n = 19) P値 年齢 70 (15) 71(10) ns 男性 [n(%)] 14 (58) 10(42) ns SAPS II 56 (15) ns SOFA 11 (3) 12 (4) ns P/F ratio 271 (146) 233 (114) ns 乳酸[mmol/L] 4. 4 (4. 0) 4. 0 (3. 2) ns 呼吸器 7 7 消化器 6 4 尿路 3 3 その他 4 5 (Mean ± SD) TPTD, transpulmonary thermodilution; CVP, central vein pressure SAPS II, simplified acute physiology score II; SOFA, sequential organ assessment score

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