Apparatus and method for measuring cardiac output

• US 5,046,505 A
• Filed: 09/05/1989
• Issued: 09/10/1991
• Est. Priority Date: 03/05/1987
• Status: Expired due to Term

• Current Assignee: Terumo Kabushiki Kaisha (Terumo Corporation)
• Original Assignee: Terumo Kabushiki Kaisha (Terumo Corporation)
• Inventors: Ikeda, Makoto, Tsuchida, Kouji, Sekii, Shigekazu
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): PONTIUS, KEVIN LANE
• Application Number:
  US07/415,298
• Time in Patent Office: 735 Days
• Field of Search: 128/691, 128/713, 128/692, 128/736
• US Class Current: 600/326
• CPC Class Codes: A61B 2560/04 Constructional details of apparatus
• CPC Class Codes: A61B 5/0275 using tracers, e.g. dye dilution
• 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
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick

Abstract

Disclosed is an apparatus for measuring a cardiac output on the basis of a dilution method. The measuring apparatus includes a switch for inputting a parameter or the like of an outer diameter or the like of a catheter, a probe for detecting the temperature of an injectate into the blood vessel by the dilution method, a switch for manually inputting the injectate temperature, a circuit for detecting non-connection of the probe, a circuit for selectively switching over the manually input injectate temperature data and the detected injectate temperature data, a catheter having an opening through which the indicator is injected, a first thermistor for measuring the temperature of the blood diluted by the indicator, and a second thermistor for detecting its heat balanced temperature obtained by being cooled by the blood, a circuit for detecting a variation in the blood temperature detected by the first thermistor and starting the integration of the area of a dilution curve in accordance with the theory of the dilution method, a circuit for continuously operating a cardiac output from the heat balanced temperature detected by the second thermistor, and a recording device for recording the continuously obtained cardiac outputs in the order in which they are operated.

Claims

1. An apparatus for measuring cardiac output by a thermal dilution method, comprising:

injection means for injecting an indicator into a blood vessel;

data setting means for manually inputting indicator data on the indicator prior to injection into the blood vessel;

measuring means for measuring injectate data on the indicator prior to injection into the blood vessel;

fault detection means for detecting that said measuring means is inoperative;

blood data detection means for detecting blood data on blood diluted by the indicator injected into the blood vessel;

integration means for integrating the blood data obtained by said blood data detection means to produce an integral value;

selection means for selecting the indicator data set by said setting means when said fault detection means detects that said measuring means is inoperative and otherwise selecting the injectate data, as selected data; and

cardiac output indication means for indicating cardiac output from the selected data and the integral value.

2. A cardiac output measuring apparatus according to claim 1,

wherein said measuring means includes a measuring probe connected to said cardiac output indication means,

wherein said fault detection means includes non-connection detection means for detecting non-connection of said measuring probe to said cardiac output indication means, and

wherein said selection means selects the indicator data as the selected data only when said non-connection detection means detects non-connection.

3. A cardiac output measuring apparatus according to claim 1, wherein said indicator data represents the temperature of the indicator.

4. A cardiac output measuring apparatus according to claim 1, wherein said data setting means includes numeric input keys.

5. An apparatus for measuring cardiac output by a thermal dilution method, having an automatic measurement starting function, comprising:

blood data detecting means for outputting blood data on blood diluted by an indicator injected into a blood vessel;

variation detection means for detecting variation in the blood data;

comparison means for comparing the variation in the blood data with a predetermined value to determine whether the variation is at least as large as the predetermined value;

integration means for performing integration of the blood data starting at a time subsequent to said comparison determining that the variation is at least as large as the predetermined value;

integration period determination means for determining an integration period of the integration performed by said integration means in dependence upon the predetermined value and a peak value of the variation in the blood data detected by said variation detection means;

integration stopping means for stopping the integration of the blood data at the end of the integration period; and

cardiac output operating means for indicating a cardiac output from the integral value of the integration performed by said integration means.

6. A cardiac output measuring apparatus according to claim 5, wherein said blood data detecting means includes a temperature sensor, and wherein the blood data represents data on the temperature of the blood diluted by the indicator injected into the blood vessel.

7. A cardiac output measuring apparatus according to claim 5, wherein said integration means includes:

determination means for determining reference data in dependence upon the variation of the blood before said comparison means performs the comparing;

operation means for integrating a difference between the blood data and the reference data each integration period; and

stoppage means for stopping the integration when the blood data substantially coincides with the reference data.

8. A cardiac output measuring apparatus according to claim 5, wherein said integration means includes:

determination means for determining reference data in dependence upon the variation of the blood before said comparison means performs the comparing;

operation means for integrating a difference between the blood data and the reference data each integration period; and

detection means for detecting a peak value of the difference, and

wherein said integration period determination means includes means for obtaining the integration period for continuing the integration in dependence upon the peak value.

9. A cardiac output measuring apparatus according to claim 5, wherein said indicator contains a dye, wherein said blood data detecting means includes a sensor for detecting the concentration of the dye in the blood as illuminance, and wherein said blood data represents illuminance data.

10. A cardiac output measuring apparatus according to claim 5, wherein said indicator contains an electrolyte, wherein said blood data detection means includes a resistance sensor for detecting a resistance of the electrolyte in the blood, and wherein said blood data represents a resistance.

11. A cardiac output measuring apparatus, comprising:

initial cardiac output measuring means for performing measurement of an initial cardiac output using a dilution method in a blood vessel at least once to obtain an initial cardiac output indication;

blood flow velocity measuring means for measuring initial blood flow velocity data and subsequent blood flow velocity data nearby a portion of the blood vessel used by said initial cardiac output measuring means;

means for independently generating a first memory pointer and a second memory pointer;

memory means for storing the initial blood flow velocity data and the subsequent blood flow velocity data measured by said blood flow velocity measuring means, at a location indicated by said first memory pointer;

data retrieving means for retrieving the initial blood flow velocity data and the subsequent blood flow velocity data using said second memory pointer;

function operation means for generating a function representing a relation between the initial cardiac output indication obtained in dependence upon the dilution method and the initial blood flow velocity data obtained when the initial cardiac output is measured;

cardiac output operation means for continuously indicating cardiac output repeatedly updated in dependence upon the function and the subsequent blood flow velocity data retrieved by said data retrieving means; and

recording means for visually and retroactively recording the cardiac output indicated by said cardiac output operation means.

12. A cardiac output measuring apparatus according to claim 11,

wherein the dilution method is a thermal dilution method,

wherein said initial cardiac output measuring means includes:

a catheter having an opening through which an indicator is injected into the blood vessel;

a first thermistor for measuring blood temperature data of blood diluted by the indicator downstream of said catheter in the blood vessel; and

integrating means for integrating the blood temperature data detected by said thermistor, and

wherein said blood flow velocity measuring means includes a second thermistor of a self-heating type, provided nearby said first thermistor of said catheter.

13. A cardiac output measuring apparatus according to claim 12, characterized by the inclusion of a first microprocessor for collecting data, a second microprocessor for processing data, and a communication means for exchanging data between said two microprocessors, wherein said first microprocessor collects the blood temperature data detected by said first thermistor and heat balanced temperature data detected by said second thermistor, and sends them to said second microprocessor by means of said communication means, and wherein said second microprocessor processes the data collected and thereby operates said initial cardiac output and said function.

14. A cardiac output measuring apparatus according to claim 11,

wherein said initial cardiac output operation means includes:

compression means for compressing a plurality of cardiac outputs detected within a predetermined period of time, and

a memory for storing the cardiac outputs compressed by said compression means, and

wherein said recording means is capable of recording the cardiac outputs compressed and stored in said memory.

15. An apparatus for continuously measuring relative changes in a cardiac output, comprising:

blood flow velocity measuring means for measuring a blood flow velocity in a blood vessel;

input means for inputting;

a cross-sectional area of the blood vessel where the blood flow velocity is measured; and

cardiac output operation means for continuously indicating relative changes in the cardiac output which occur over time in dependence upon the cross-sectional area of the blood vessel and the blood flow velocity measured by said blood flow velocity measuring means.

16. A measuring method for measuring cardiac output using a thermal dilution method, comprising the steps of:

(a) storing, into a memory table prior to measuring the cardiac output, correction data on heat capacity of an indicator;

(b) injecting the indicator into a blood vessel;

(c) detecting blood data on blood diluted by the indicator injected in step (b);

(d) retrieving the correction data from the memory table in dependence upon heat capacity data for the indicator;

(e) calculating a time integration value using the blood data; and

(f) indicating a cardiac output in dependence upon the time integration value and the correction data, in accordance with the thermal dilution method.

17. A measuring method according to claim 16, wherein said blood data represents temperature of the blood.

18. A measuring method according to claim 16, wherein said heat capacity data represents volume of the indicator injected in step (b).

19. A measuring method according to claim 16,

wherein said injecting in step (b) injects the indicator into the blood vessel via a catheter having an outer diameter, and

wherein the heat capacity data represents the outer diameter of the catheter.

20. A measuring method according to claim 16,

wherein said injecting in step (b) injects the indicator into the blood vessel via a catheter, and

wherein said heat capacity data represents temperature of the indicator.

21. A measuring method according to claim 16, further comprising the step of (g) inputting the heat capacity data of the indicator via numeric input keys.