Method and apparatus for continuous measurement of cardiac output and SVR

• US 5,265,615 A
• Filed: 12/18/1992
• Issued: 11/30/1993
• Est. Priority Date: 12/18/1992
• Status: Expired due to Fees

• Current Assignee: Eyal Frank, Yuval Raich
• Original Assignee: Eyal Frank, Yuval Raich
• Inventors: Frank, Eyal, Raich, Yuval
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Sykes, Angela D.
• Application Number:
  US07/992,756
• Time in Patent Office: 347 Days
• Field of Search: 128/672-686, 128/713, 128/734, 128/691-694, 128/670-671
• US Class Current: 600/485
• 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 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7242 using integration

Abstract

A method of continuously monitoring cardiac output and SVR of a patient by analyzing the blood pressure signal. The signal can be measured directly by the use of catheters placed into various arteries, in particular a radial artery or a femoral artery, or non-invasive methods such as electrooptic means, or using a piezoelectric pressure transducer. Various parameters are extracted from the blood pressure signal waveform in order to calculate the cardiac output of the patient and other hemodynamic data.

Claims

1. A method for measuring cardiac output and system vascular resistance (SVR) of a patient by analyzing the patient'"'"'s blood pressure signal waveform, wherein said waveform includes a plurality of successive peaks corresponding to a plurality of systolic and diastolic portions of the signal, comprising the steps of:

(a) detecting an analog signal representative of the blood pressure of the patient;

(b) converting said analog signal to a digital signal;

(c) low-pass filtering said digital signal;

(d) extracting a plurality of parameters from said filtered digital signal; and

(e) calculating cardiac output and SVR values on the basis of said extracted parameters,

wherein said step of extracting includes determining an interval of time between a point of maximum pressure of a systolic portion of said blood pressure signal waveform and a point at which a first dicrotic notch following said point of maximum pressure is detected.

2. The method for measuring cardiac output and SVR of a patient according to claim 1, further comprising the step of inputting a BSA value which represents the body surface area of the patient, for use in the step of calculating said cardiac output and said SVR values.

3. The method for measuring cardiac output and SVR of a patient according to claim 1, further comprising the step of displaying the cardiac output and SVR of the patient.

4. The method for measuring cardiac output and SVR of a patient according to claim 1, wherein said step of extracting includes determining a point of minimum pressure of a diastolic portion of said blood pressure signal waveform following said systolic portion, a mean pressure value of said systolic and diastolic portions, and an amplitude of said waveform.

5. The method for measuring cardiac output and SVR of a patient according to claim 4, wherein said step of extracting further includes determining a heart rate, a pulse pressure value, and a time interval between the beginning of the systolic portion of said waveform and the peak of said systolic portion.

6. The method for measuring cardiac output and SVR of a patient according to claim 5, wherein said step of extracting further includes determining a signal square root integral and a rise square root integral of said blood pressure signal waveform.

7. The method for measuring cardiac output and SVR of a patient according to claim 6, wherein said step of extracting further includes determining maximum and minimum values of first and second derivatives of said blood pressure signal waveform.

8. The method for measuring cardiac output and SVR of a patient according to claim 7, wherein a patient'"'"'s cardiac output is determined by the equation ##EQU3## where α

is a constant, s represents the minimum peak of the second derivative, h is the rise time of the signal, m is equal to the signal square root integral, n equals rise square root integral, f equals heart rate per minute, d is the amplitude of the waveform, BSA represents the patient'"'"'s body surface area, a equals systolic peak pressure, i equals time interval between the point of maximum pressure of the systolic portion and the point at which the dicrotic notch is detected, p equals the maximum value of the first derivative, r equals the first maximum value of the second derivative, and t equals the second maximum value of the second derivative.

9. The method for measuring cardiac output and SVR of a patient according to claim 7, wherein the patient'"'"'s system vascular resistance is calculated by the equation ##EQU4## where α

is a constant, e equals the average amplitude of the systolic and diastolic portions, r equals the first maximum value of the second derivative, b equals the diastolic pressure, i equals the time interval between the point of maximum pressure of the systolic portion and the point at which the dicrotic notch is detected, m equals the signal square root integral, n equals the rise square root integral, p equals the maximum peak of the first derivative, q equals the minimum peak of the first derivative, h equals the rise time of the integral, d equals the amplitude of the signal waveform, g equals systolic minus diastolic pressure, s equals the minimum peak of the second derivative, and BSA equals the body surface area of the patient.

10. A system for measuring cardiac output and system vascular resistance (SVR) of a patient by analyzing a blood pressure signal waveform of the patient, comprising:

means for detecting an analog signal representative of the blood pressure of the patient;

means for converting said analog signal to a digital signal;

means for low-pass filtering said digital signal;

means for extracting a plurality of parameters from said filtered digital signal; and

means for calculating a cardiac output value and an SVR value on the basis of said extracted parameters,

wherein said means for extracting includes a means for determining an interval of time between a point of maximum pressure of a systolic pressure of said blood pressure signal waveform and a point at which a first dicrotic notch following said point of maximum pressure is detected.

11. The system for measuring cardiac output and SVR of a patient according to claim 10, further comprising means for inputting a BSA value which represents the body surface area of the patient for use by the calculating means for calculating said cardiac output and said SVR.

12. The system for measuring cardiac output and SVR of a patient according to claim 10, further comprising a means for displaying the cardiac output and SVR of the patient.

13. The system for measuring cardiac output and SVR of a patient according to claim 10, wherein said means for extracting includes a means for determining a point of minimum pressure of the diastolic portion of said blood pressure signal waveform following said systolic portion, a mean pressure value of said systolic and diastolic portions, and an amplitude of said waveform.

14. The system for measuring cardiac output and system vascular resistance of a patient according to claim 13, wherein said means for extracting further includes means for determining a heart rate, a pulse pressure, and a time interval between the beginning of the systolic portion of said waveform and the peak of said systolic portion.

15. The system for measuring cardiac output and SVR of a patient according to claim 14, wherein said means for extracting further includes a means for determining a signal square root integral and a rise square root integral of said blood pressure signal waveform.

16. The system for measuring cardiac output and SVR of a patient according to claim 15, wherein said means for extracting further includes a means for determining the maximum and minimum values of first and second derivatives of said blood pressure signal waveform.

17. The system for measuring cardiac output and SVR o a patient according to claim 16, wherein a patient'"'"'s cardiac output is determined by the equation ##EQU5## where α

is a constant, s equals the minimum peak of the second derivative, h equals the rise time of the signal, m equals signal square root integral, n equals rise square root integral, f equals heart rate per minute, d equals amplitude of the waveform, BSA equals the patient'"'"'s body surface area, a equals systolic peak pressure, i equals time interval between the point of maximum pressure of the systolic portion and the point at which the dicrotic notch is detected, p equals the maximum value of the first derivative, r equals the first maximum value of the second derivative, and t equals the second maximum value of the second derivative.

18. The system for measuring cardiac output and SVR of a patient, according to claim 16, wherein the patient'"'"'s SVR is calculated by the equation ##EQU6## where α

equals a constant, e equals the average amplitude of the systolic and diastolic portions, r equals the first maximum value of the second derivative, b equals the diastolic pressure, i equals the time interval between the point of maximum pressure of the systolic portion and the point at which the dicrotic notch is detected, m equals the signal square root integral, n equals the rise square root integral, p equals the maximum peak of the first derivative, q equals the minimum peak of the first derivative, h equals the rise time of the integral, d equals the amplitude of the signal waveform, g equals systolic minus diastolic pressure, s equals the minimum peak of the second derivative, and BSA equals the body surface area of the patient.