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가상출혈에서 혈관내 용적 지표로서 호흡성 맥파전도시간 변이의 측정
전인구 ( In Gu Jun ),박종연 ( Jong Yeon Park ),상보현 ( Bo Hyun Sang ),박준영 ( Jun Young Park ),주자영 ( Ja Young Joo ),황규삼 ( Gyu Sam Hwang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3
Background: We examined the usefulness of respiratory pulse transit time (PTT) variation as an intravascular volume index in young, healthy, spontaneous, paced breathing volunteers exposed to simulated central hypovolemia by lower body negative pressure (LBNP). Methods: With paced breathing at 0.25 Hz, beat-to-beat finger blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR), and PTT were measured non-invasively in 18 healthy volunteers. Graded central hypovolemia was generated using LBNP from 0 to -20, -30, -40, and -50 mmHg. Respiratory PTT variation (PTTV) was calculated as the difference of maximal and minimal values divided by their respective means. Respiratory-frequency PTT variability (PTTRF) using power spectral analysis was also estimated. Results: During LBNP, SV, CO and PTT(RF) decreased, but PTT, PTTV and TPR increased significantly. PTTV did not correlate with SV changes (r=-0.08, P=0.52), but PTT(RF) (r=0.58, P<0.01) and PTT (r=0.43, P<0.01) did during progressive hypovolemia. Conclusions: PTT(RF) is more applicable to the changes in intravascular volume than PTT and PTTV, suggesting spectral analysis of PTT might be used as a dynamic preload index in patients with spontaneous and paced breathing condition, which needs further studies. (Korean J Anesthesiol 2009; 56: 265~72)
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