Estimating cardiac output from pulmonary arterial pressure

Kirchner J, van Ooyen A, Pfennig M, Schmitz-Rode T, Urbaszek A (2011)

Publication Language: English

Publication Type: Conference contribution, Abstract of lecture

Publication year: 2011

Conference Proceedings Title: Biomedizinische Technik. Biomedical engineering, vol. 56, iss. s1

Event location: Freiburg DE

URI: https://www.degruyter.com/view/j/bmte.2011.56.issue-s1/bmt.2011.824/bmt.2011.824.xml

DOI: 10.1515/BMT.2011.345

Abstract

Introduction
Cardiac output (CO) and stroke volume (SV) are fundamental physiologic parameters for diagnosis and monitoring of congestive  heart  failure.  Methods  for  estimating  these  quantities  from  continuous  blood  pressure  measurements,  typically from aortic pressure, are known as pulse contour analysis (PCA). In an acute animal study, different methods of PCA were evaluated for applicability to continuously calculating CO and SV from pulmonary arterial blood pressure.

Methods
Acute experiments were performed with anesthetized Rhoen sheep with high-rate paced rhythm. Cardiac output was varied by a stepwise increase of dobutamine dosage, accompanied by constant administration of saline solution. Blood pressure was measured continuously in the left and right ventricle as well as in the aorta and the pulmonary artery by use of two pressure transducer catheters (Micro-Tip, Millar instruments). As a reference, CO was determined by use of the thermodilution method (Vigilance Monitor, Edwards Lifesciences). Stroke volume was determined by use of several methods from literature, including the use of pulse pressure, pressure integral and triangular approximations of pressure area. Cardiac output was calculated by multiplication by heart rate.

Results
All estimates of CO from PCA exhibit an excellent agreement with the measurement protocol, i.e. increased CO when contractility is raised. These observations are further supported by comparison to (dP/dt)max, which is regarded as a measure of contractility. The different methods show very similar behavior and vary only in the relative changes. The results from PCA agree well with the reference measurement with the thermodilution method. Calculated CO even shows a significantly quicker response to changes in physiologic condition compared to the Vigilance measurements.

Conclusion
Estimations of CO and SV from PCA reflect changes in physiologic condition on a beat-to-beat basis. Continuous monitoring of cardiac condition, particularly detection of a worsening of heart failure, is feasible using measurements of pulmonary arterial pressure.

Authors with CRIS profile

Jens Kirchner Lehrstuhl für Technische Elektronik (LTE)

Involved external institutions

BIOTRONIK SE & Co. KG DE Germany (DE) Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen DE Germany (DE)

How to cite

APA:

Kirchner, J., van Ooyen, A., Pfennig, M., Schmitz-Rode, T., & Urbaszek, A. (2011). Estimating cardiac output from pulmonary arterial pressure. Paper presentation at 45. DGBMT Jahrestagung (BMT 2011), Freiburg, DE.

MLA:

Kirchner, Jens, et al. "Estimating cardiac output from pulmonary arterial pressure." Presented at 45. DGBMT Jahrestagung (BMT 2011), Freiburg 2011.

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