Cardiac output detection by multiple frequency thermodilution

• US 4,236,527 A
• Filed: 10/20/1978
• Issued: 12/02/1980
• Est. Priority Date: 10/20/1978
• Status: Expired due to Term

• Current Assignee: Massachusetts General Hospital (Mass General Brigham, Inc.)
• Original Assignee: Massachusetts General Hospital (Mass General Brigham, Inc.)
• Inventors: Newbower, Ronald S., Philip, James H.
• Primary Examiner(s): Michell, Robert W.
• Assistant Examiner(s): Jaworski, Francis J.
• Application Number:
  US05/953,124
• Time in Patent Office: 774 Days
• Field of Search: 128/653-663, 128/691-694, 128/713, 73/204, 73/194 R, 73/194 E, 73/194 M
• US Class Current: 600/505
• 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

Method and apparatus for measuring cardiac output in which a traceable signal in the form of thermal energy or an injectate is applied to the blood flow through the heart having a plurality of frequency components with the traceable signal detected at a heart output vessel and analyzed at the plural frequency components to provide cardiac output rate and ejection fraction information. The traceable signal is preferably heat energy applied as a very low frequency modulation of a high frequency signal at a fundamental and further harmonic or as a square wave in which multiple harmonics are present. At least two frequency components of the square wave are then separately analyzed. A multiple frequency system in addition to permitting analysis of previously undetectable heart output characteristics additionally permits determination of whether the source of the traceable signal is properly located within the heart such as in the ventricle.

Claims

1. Apparatus for cardiac thermodilution measurement comprising:

means for applying a traceable signal by injection of thermal energy for dilution in the blood flow in a location upstream of a heart output conduit;

means for varying the magnitude of the traceable signal as a function of time at at least two frequencies thereby varying the amount of thermal energy applied to the blood flow;

means for detecting said traceable signal as blood flow temperature downstream of the heart ventricle at the first of said at least two frequencies; and

means for separately detecting at least the second of said at least two frequencies in said traceable signal as blood flow temperature downstream of the ventricle of said heart.

2. The process of claim 1 wherein:

said step of detecting said first frequency includes the step of detecting the peak value of said traceable signal at said first frequency;

said step of detecting at least said second frequency includes the step detecting the peak value of said traceable signal at said second frequency.

3. The process of claim 2 further including the step of determining the cardiac transfer function between sites of application of the traceable signal and of its detection.

4. The process of claim 1 wherein:

the signal applying step includes the step of applying a square wave signal;

the first frequency is the fundamental frequency of said square wave signal and;

said at least second frequency is multiple harmonics above said first frequency.

5. The process of claim 4 wherein said step of detecting the traceable signal at said at least second frequency includes the step of detecting the square wave rise time.

6. The process of claim 5 further including the step of determining the cardiac transfer function between sites of application of the traceable signal and of its detection.

7. The process of claim 6 wherein said step of detecting the first frequency of said traceable signal includes the step of peak detecting said signal at said first frequency.

8. The process of claim 4 wherein said separate detecting step includes detecting the peak value of at least one frequency of said multiple harmonics.

9. The process of claim 1 wherein said step of applying first and at least a second frequency of a traceable signal includes the step of modulating a frequency higher than said first and at least second frequencies at the rates of said first and at least second frequencies.

10. The process of claim 1 wherein said step of applying said traceable signal includes the step of applying said traceable signal to a heart ventricle.

11. A process for detecting pump output characteristics in a pump of the type having a chamber of reducible volume which is periodically reduced and expanded in a cyclical fashion at a known rate along with inlet and outlet conduits and corresponding valves to promote the flow of a fluid material in a predetermined direction from said inlet to said outlet conduit, a process for detecting flow characteristics comprising:

applying a traceable signal in the form of thermal energy or an injectate varying in magnitude at a first and at least a second distinct frequency to the reducible volume of said chamber at a first location to mix with and be diluted by said fluid material;

detecting in said outlet at a second location downstream of said first location said traceable signal as mixed with and diluted by said fluid material at said first frequency;

detecting in said outlet conduit said traceable signal as mixed with and diluted by said fluid material at at least second frequency.

12. Apparatus for cardiac thermodilution measurement comprising:

means for applying a traceable signal by injection of thermal energy for dilution in the blood flow in a location upstream of a heart output conduit;

means for varying the magnitude of the traceable signal as a function of time at at least two frequencies thereby varying the amount of thermal energy applied to the blood flow;

means for detecting said traceable signal as blood flow temperature downstream of the heart ventricle at the first of said at least two frequencies; and

means for separately detecting at least the second of said at least two frequencies in said traceable signal as blood flow temperature downstream of the ventricle of said heart.

13. A process for detecting flow output characteristics of a fluid material through a chamber with a mixing volume having an outlet conduit, said process for detecting flow output characteristics comprising:

applying a traceable signal in the form of thermal energy or an injectate varying in magnitude at a first and at least a second distinct frequency to the mixing volume of said chamber;

detecting in said outlet conduit at a second location downstream of said first location said traceable signal as mixed with and diluted by said fluid material at said first frequency;

detecting in said outlet conduit said traceable signal as mixed with and diluted by said fluid material at at least said second frequency.

14. A process for detecting pump output characteristics in a pump of the type having a chamber of reducible volume which is periodically reduced and expanded in a cyclical fashion at a known rate along with inlet and outlet conduits and corresponding valves to promote the flow of a fluid material in a predetermined direction from said inlet to said outlet conduit, a process for detecting flow characteristics comprising:

applying a traceable signal in the form of thermal energy or an injectate varying in magnitude at a first and at least a second distinct frequency to the reducible volume of said chamber at a first location to mix with and be diluted by said fluid material;

detecting in said outlet conduit at a second location downstream of said first location said traceable signal as mixed with and diluted by said fluid material at said first frequency;

detecting in said outlet conduit said traceable signal as mixed with and diluted by said fluid material at at least second frequency.