Apparatus and method for measuring extravascular lung water

• US 4,230,126 A
• Filed: 11/20/1978
• Issued: 10/28/1980
• Est. Priority Date: 11/20/1978
• Status: Expired due to Term

• Current Assignee: Baxter International Inc.
• Original Assignee: Virgil B. Elings
• Inventors: Elings, Virgil B.
• Primary Examiner(s): Howell, Kyle L.
• Application Number:
  US05/962,308
• Time in Patent Office: 708 Days
• Field of Search: 128/659, 128/713, 128/656, 128/670, 128/671, 128/716, 128/630, 128/692
• US Class Current: 600/484
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/028 by thermo-dilution
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence

Abstract

Apparatus for providing a measure of extravascular lung water of a subject using a single thermal indicator, including means for providing an injection of the thermal indicator into the bloodstream of the subject at a position proximal to or in the right heart, means for detecting a first time-temperature concentration curve of the bloodstream at a position in the pulmonary artery, means responsive to the first time-temperature concentration curve detected in the pulmonary artery for calculating a characteristic time for the first time-temperature concentration curve, means for detecting a second time-temperature concentration curve of the bloodstream at a position in a systemic artery, means responsive to the second time-temperature concentration curve detected in the sytemic artery for calculating a characteristic time for the second time-temperature concentration curve, means for calculating the flow of blood through the heart and lungs, and means for calculating a measure of extravascular lung water in accordance with the difference between the products of the blood flow times the first characteristic time and the blood flow times the second characteristic time.

Claims

1. Apparatus for providing a measure of extravascular lung water of a subject using a single thermal indicator, including

means for providing an injection of the thermal indicator into the bloodstream of the subject at a position proximal to or in the right heart,

means for detecting a first time-temperature concentration curve of the bloodstream at a position in the pulmonary artery,

means responsive to the first time-temperature concentration curve detected in the pulmonary artery for calculating a characteristic time for the first time-temperature concentration curve,

means for detecting a second time-temperature concentration curve of the bloodstream at a position in a systemic artery,

means responsive to the second time-temperature concentration curve detected in the systemic artery for calculating a characteristic time for the second time-temperature concentration curve,

means for calculating the flow of blood through the heart and lungs, and

means for calculating a measure of extravascular lung water in accordance with the product of the blood flow times the difference between the characteristic times for the first and second time-temperature concentration curves.

2. The apparatus for providing a measure of extravascular lung water of claim 1 wherein the means for calculating the characteristic times for the first and second time-temperature concentration curves includes means for calculating the exponential decay times for the curves.

3. The apparatus for providing a measure of extravascular lung water of claim 1 wherein the means for calculating the characteristic times for the first and second time-temperature concentration curves includes means for calculating the mean times for the curves.

4. The apparatus for providing a measure of extravascular lung water of claim 1 wherein the means for calculating the flow of blood calculates the blood flow in accordance with characteristics of the second time-temperature concentration curve of the bloodstream at the position in the systemic artery.

5. The apparatus for providing a measure of extravascular lung water of claim 4 wherein the means for calculating the flow of blood includes means for calculating the blood flow in accordance with the reciprocal of the area under the second time-temperature curve.

6. The apparatus for providing a measure of extravascular lung water of claim 1 wherein the means for detecting the first and second time-temperature concentration curves in the pulmonary and systemic arteries includes catheters for insertion into the pulmonary and systemic arteries and with each catheter including at least one temperature sensitive element.

7. The apparatus for providing a measure of extravascular lung water of claim 1 additionally including means for indicating the measure of extravascular lung water.

8. Apparatus for providing a measure of extravascular lung water of a subject including means for providing an injection of a thermal indicator into the bloodstream of the subject at a position proximal to or in the right heart, including

means for detecting the time-temperature concentration curve of the bloodstream at a position in a systemic artery,

first means responsive to the time-temperature concentration curve detected in the systemic artery for calculating a characteristic time for the time-temperature curve,

second means responsive to the time-temperature concentration curve detected in the systemic artery for calculating the cardiac output in accordance with the reciprocal of the area under the time-temperature curve, and

means for calculating a measure of extravascular lung water including the product of the cardiac output times the characteristic time.

9. The apparatus for providing a measure of extravascular lung water of claim 8 wherein the first means for calculating a characteristic time for the time-temperature curve includes means for calculating the exponential decay time for the curve.

10. The apparatus for providing a measure of extravascular lung water of claim 8 wherein the first means for calculating a characteristic time for the time temperature curve includes means for calculating the mean time for the curve.

11. The apparatus for providing a measure of extravascular lung water of claim 8 wherein the means for detecting the time-temperature concentration curve in the systemic artery includes a catheter for insertion into the systemic artery and with the catheter including a temperature sensitive device.

12. The apparatus for providing a measure of extravascular lung water of claim 11 wherein the temperature sensitive device includes a thermistor having resistance values in accordance with the temperature of the bloodstream in the systemic artery.

13. The apparatus for providing a measure of extravascular lung water of claim 8 additionally including means for indicating the measure of extravascular lung water.

14. Apparatus for providing a measure of extravascular lung water of a subject using a single thermal indicator, including

means for providing an injection of the thermal indicator into the bloodstream of the subject at a position proximal to or in the right heart,

means for detecting a first temperature dilution curve of the bloodstream at a position in the pulmonary artery,

means responsive to the first temperature dilution curve detected in the pulmonary artery for calculating a characteristic time for the first temperature dilution curve,

means for detecting a second temperature dilution curve of the bloodstream at a position in a systemic artery, p1 means responsive to the second temperature dilution curve detected in the systemic artery for calculating a characteristic time for the second temperature dilution curve,

means responsive to a temperature dilution curve of the bloodstream for calculating the flow of blood through the heart and lungs, in accordance with characteristics of the temperature dilution curve, and

means for calculating a measure of extravascular lung water in accordance with the difference between the product of the flow times the characteristic time for the first temperature dilution curve and the product of the flow times the characteristic time for the second temperature dilution curve.

15. The apparatus for providing a measure of extravascular lung water of claim 14 wherein the means for calculating the flow of blood is responsive to both the temperature dilution curve in the pulmonary artery and the temperature dilution curve in the systemic artery and the means for calculating a measure of extravascular lung water calculates the difference between the products of the flow calculated from the second dilution curve multiplied by the characteristic time for that curve and the flow calculated from the first dilution curve multiplied by the characteristic time for that curve.

16. The apparatus for providing a measure of extravascular lung water of claim 14 wherein the means for calculating the flow of blood includes means for calculating the blood flow in accordance with the reciprocal of the area under the dilution curve.

17. The apparatus for providing a measure of extravascular lung water of claim 14 wherein the means for calculating the flow of blood includes means for calculating the blood flow in accordance with the second dilution curve detected in the systemic artery.

18. The apparatus for providing a measure of extravascular lung water of claim 17 wherein the means for calculating the flow of blood includes means for calculating the blood flow in accordance with the reciprocal of the area under the dilution curve.

19. The apparatus for providing a measure of extravascular lung water of claim 16 additionally including means for indicating the measure of extravascular lung water.

20. The apparatus for providing a measure of extravascular lung water of claim 14 wherein the means for calculating the characteristic times for the first and second temperature dilution curves includes means for calculating the exponential decay times for the curves.

21. The apparatus for providing a measure of extravascular lung water of claim 14 wherein the means for calculating the characteristic times for the first and second temperature dilution curves includes means for calculating the mean times for the curves.

22. The apparatus for providing a measure of extravascular lung water of claim 14 wherein the means for detecting the first and second temperature dilution curves in the pulmonary and systemic arteries includes catheters for insertion into the pulmonary and systemic arteries and with each catheter including at least one temperature sensitive element.

23. A method of measuring the extravascular lung water of a subject using a single thermal indicator, including the following steps

providing an injection of the thermal indicator into the bloodstream of the subject at a position proximal to or in the right heart,

detecting a first time-temperature concentration curve of the blood stream at a position in the pulmonary artery,

calculating a characteristic time for the first time-temperature concentration curve,

detecting a second time-temperature concentration curve of the bloodstream at a position in a systemic artery,

calculating a characteristic time for the second time-temperature concentration curve,

providing a calculation for the flow of blood through the heart and lungs, and

calculating a measure of extravascular lung water in accordance with the product of the blood flow times the difference between the characteristic times for the first and second time-temperature concentration curves.

24. The method of measuring the extravascular lung water of claim 23 wherein the characteristic times calculated for the first and second time-temperature concentration curves are the exponential decay times for the curves.

25. The method of measuring the extravascular lung water of claim 23 wherein the characteristic times calculated for the first and second time-temperature concentration curves are the mean times for the curves.

26. The method of measuring the extravascular lung water of claim 23 wherein the calculation for the flow of blood includes calculating the blood flow in accordance with characteristics of the second time-temperature concentration curve of the blood stream at the position in the systemic artery.

27. The method of measuring the extravascular lung water of claim 26 wherein the flow of blood is calculated in accordance with the reciprocal of the area under the second time-temperature curve.

28. The method of measuring the extravascular lung water of claim 23 wherein the detecting of the first and second time-temperature concentration curves in the pulmonary and systemic arteries includes inserting catheters having temperature sensitive elements into the pulmonary and systemic arteries.

29. The method of measuring the extravascular lung water of claim 23 additionally including the step of indicating the measure of extravascular lung water.

30. A method for measuring the extravascular lung water of a subject using a single thermal indicator and with the measure of extravascular lung water calculated from the product of the cardiac output times the difference between characteristic times determined from thermal dilution curves detected in systemic and pulmonary arteries, and with the method including the following steps

providing a first catheter having an opening for injecting the thermal indicator and including a temperature sensitive device,

providing a second catheter including a temperature sensitive device,

inserting the first catheter through the right heart and into the pulmonary artery,

inserting the second catheter into a systemic artery,

injecting the thermal indicator proximal to or in the right heart,

detecting the temperature dilution curve of the bloodstream within the pulmonary artery, and

detecting the temperature dilution curve of the bloodstream within the systemic artery.

31. A method for measuring the extravascular lung water of a subject wherein an injection of a thermal indicator is provided into the bloodstream of the subject at a position proximal to or in the right heart, including the following steps

detecting the time-temperature concentration curve of the bloodstream at a position in a systemic artery,

calculating a characteristic time for the time-temperature curve,

calculating the cardiac output in accordance with the characteristics of the time-temperature curve, and

calculating the measure of extravascular lung water including the product of the cardiac output times the characteristic time.

32. The method for measuring the extravascular lung water of claim 31 wherein the characteristic time calculated for the time-temperature curve is the exponential decay time for the curve.

33. The method for measuring the extravascular lung water of claim 31 wherein the characteristic time calculated for the time-temperature curve is the mean time for the curve.

34. The method for measuring the extravascular lung water of claim 31 wherein the detecting of the time-temperature concentration curve in the systemic artery includes inserting a catheter having a temperature sensitive device.

35. The method for measuring the extravascular lung water of claim 31 additionally including the step of indicating the measure of extravascular lung water.

36. A method for measuring the extravascular lung water of a subject using a single thermal indicator, including

injecting the thermal indicator into the bloodstream of the subject at a position proximal to or in the right heart,

detecting a first temperature dilution curve of the bloodstream at a position in the pulmonary artery,

calculating a characteristic time for the first temperature dilution curve,

detecting a second temperature dilution curve of the bloodstream at a position in a systemic artery,

calculating a characteristic time for the second temperature dilution curve,

calculating the flow of blood through the heart and lungs in accordance with characteristics of a temperature dilution curve, and

calculating a measure of extravascular lung water in accordance with the difference between the product of the blood flow times the characteristic time for the first curve and the product of the blood flow times the characteristic time for the second curve.

37. The method of measuring the extravascular lung water of claim 36 in which the flow of blood through the heart and lungs is calculated from the dilution curve in both the pulmonary artery and systemic artery and the calculation of a measure of extravascular lung water is in accordance with the difference between the product of the flow calculated from the systemic arterial dilution curve times the characteristic time for that curve and the product of the flow calculated from the pulmonary artery curve times the characteristic time for that curve.

38. The method of measuring the extravascular lung water of claim 36 wherein the flow of blood is calculated in accordance with the reciprocal of the area under a dilution curve.

39. The method of measuring the extravascular lung water of claim 36 wherein the calculating of the flow of blood is responsive to the second dilution curve detected in the systemic artery.

40. The method of measuring the extravascular lung water of claim 39 wherein the flow of blood is calculated in accordance with the reciprocal of the area under the dilution curve.

41. The method of measuring the extravascular lung water of claim 36 additionally including the step of indicating the measure of extravascular lung water.

42. The method of measuring the extravascular lung water of claim 36 wherein the characteristic times calculated for the first and second temperature dilution curves are the exponential decay times for the curves.

43. The method of measuring the extravascular lung water of claim 36 wherein the characteristic times calculated for the first and second temperature dilution curves are the mean times for the curves.

44. The method of measuring the extravascular lung water of claim 36 wherein detecting the first and second temperature dilution curves in the pulmonary and systemic arteries includes inserting catheters having temperature sensitive devices into the pulmonary and systemic arteries.