System for calculating compliance and cardiac hemodynamic parameters

• US 5,423,323 A
• Filed: 08/30/1993
• Issued: 06/13/1995
• Est. Priority Date: 08/30/1993
• Status: Expired due to Fees

• Current Assignee: Rocky Mountain Research Incorporated
• Original Assignee: Rocky Mountain Research Incorporated
• Inventors: Orth, Jeffrey L.
• Primary Examiner(s): Sykes, Angela D.
• Application Number:
  US08/114,314
• Time in Patent Office: 652 Days
• Field of Search: 128/673, 128/675, 128/691-694, 128/713, 128/736, 128/748, 128/668
• US Class Current: 600/486
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/027 using catheters

Abstract

A catheter set (10) is used in connection with a blood flow monitor and calibration system (80) to determine the compliance C of a vessel according to the equation C=dV2/ (PE-PA), where dV2 is the change in volume of the vessel created by the change in volume (e.g., deflation) of a displacement balloon (30) adjacent to a catheter (14), PE is an estimate of what the pressure measured by a pressure transducer (56) or a strain gage (78) would have been but for the change in volume of the displacement balloon at a particular time, and PA is the actual pressure measured by the transducer at the particular time. The determined compliance is more accurate than that obtained through thermal dilution procedures. The determined value of compliance C may then be used in calculation of blood flow. In addition, pulmonary vascular resistance and systemic vascular resistance may calculated through procedures and in equations using the determined compliance without directly measuring the pulmonary capillary wedge pressure.

Claims

1. A system for determining compliance of a vessel, the system comprising:

a displacement balloon insertable into the vessel;

a tube having at least first and second openings, the first opening being connected to the displacement balloon;

an adjustable pressure source connected to the second opening of the tube that selectively changes volume of the displacement balloon by an amount, thereby changing volume of the vessel by essentially the amount;

pressure detecting means for measuring blood pressure in the vessel at a position near the displacement balloon and generating a pressure signal indicative of the measured blood pressure; and

processing means for receiving the pressure signal, determining change in blood pressure caused by the change in volume of the displacement balloon, and determining the compliance based on the change in volume and the change in blood pressure.

2. The system of claim 1 in which compliance C is determined according to an equation C =dV2 / (PE-PA), where C is the compliance, dV2 is the change in volume created by the displacement balloon, PE is an estimate of what the blood pressure would have been but for the change in volume of the displacement balloon at a particular timer and PA is the actual blood pressure at the particular time.

3. The system of claim 1 in which the displacement balloon is positioned adjacent a catheter and in which the pressure detecting means is a miniaturized strain gage placed adjacent to the catheter.

4. The system of claim 1 in which the displacement balloon is positioned adjacent a catheter and in which the pressure detecting means is a fibre optic pressure transducer placed adjacent to the catheter.

5. The system of claim 1 in which the processing means detects peak systole and the processing means controls the adjustable pressure source in response to the detection of peak systole.

6. The system of claim 1 further comprising a second tube with a first opening near the displacement balloon and a second opening connected to the pressure detecting means.

7. The system of claim 1 in which in the function of determining of the change in blood pressure caused by the change in volume of the displacement balloon performed by the processing means includes estimating what the blood pressure would have been at a particular time but for the change in the volume of the displacement balloon.

8. The system of claim 1 in which the change in volume is a decrease in volume of the displacement balloon.

9. The system of claim 1 in which the vessel is the pulmonary artery.

10. The system of claim 1 in which the displacement balloon also acts as a floatation balloon.

11. The system of claim 1 in which the processing means calculates blood flow through an equation that includes the determined compliance.

12. The system of claim 11 in which all variables of in the equation are derived from the pressure detecting means.

13. The system of claim 1 in which the processing means calculates pulmonary vascular resistance through an equation that includes the determined compliance.

14. The system of claim 13 in which all variables of in the equation are derived from the pressure detecting means.

15. The system of claim 1 in which the processing means calculates systemic vascular resistance through an equation that includes the determined compliance.

16. A system for determining compliance of a vessel, the system comprising:

a catheter that is insertable into the vessel;

a tube having at least first and second openings, the first opening being positioned in the vessel;

an adjustable pressure source that holds fluid and that is connected to the second opening of the tube, the adjustable pressure source selectively changes volume of fluid in the adjustable pressure source by a predetermined amount, thereby changing volume of the vessel by essentially the predetermined amount;

pressure detecting means for measuring blood pressure in the vessel and generating a pressure signal indicative of the measured blood pressure; and

processing means for receiving the pressure signal, determining change in blood pressure caused by the change in volume of the fluid, and determining the compliance through an equation that includes the change in volume and the change in blood pressure.

17. The system of claim 16 in which the adjustable pressure source changes the volume of fluid in the adjustable pressure source by injecting fluid into the vessel.

18. The system of claim 16 in which the adjustable pressure source changes the volume of fluid in the adjustable pressure source by withdrawing fluid from the vessel.

19. A method for determining compliance of a vessel, the method comprising the steps of:

inserting a displacement balloon into the vessel, the displacement balloon being connected to a first opening of a tube having at least first and second openings, the second end being connected to an adjustable pressure source;

changing the pressure of the adjustable pressure source so as to change volume of the displacement balloon by a predetermined amount;

sensing blood pressure in the vessel at a position near the displacement balloon;

determining change in blood pressure caused by the change in volume of the displacement balloon, and determining the compliance through an equation that includes the change in volume and the change in blood pressure.

20. A method for calculating blood flow in a vessel, the method comprising:

determining the compliance of the vessel by determining a change in pressure caused by a change in volume in the vessel; and

calculating the blood flow according to an equation in which the compliance is a parameter.

21. A system for calculating blood flow of blood in a vessel of a subject, comprising:

a displacement balloon that is insertable into the vessel;

a tube having at least first and second openings, the first opening being connected to the displacement balloon;

an adjustable pressure source connected to the second opening of the tube that selectively changes volume of the displacement balloon by an amount, thereby changing the volume of the vessel by essentially the amount;

pressure detecting means for measuring blood pressure in the vessel at a position near the displacement balloon and generating a pressure signal indicative of the measured blood pressure;

processing means for receiving the pressure signal, determining change in blood pressure caused by the change in volume of the displacement balloons and determining the compliance based on an equation that includes the change in volume and the change in blood pressure;

the processing means using the pressure signal for measuring heart rate (F) of the subject, for measuring an average pressure (Pcd) in the arterial tree of the subject at end of systole, measuring an average pressure (Pab) in the arterial tree of the subject at end of diastole, generating an arterial pressure curve of the subject during systolic drainage and an arterial pressure curve of the subject during diastolic drainage, measuring area (Sa) under the arterial pressure curve during systolic drainage, measuring area (Da) under the arterial pressure curve during diastolic drainage, and calculating BF according to an equation BF=C×

F (Pcd-Pab) (1+Sa/Da).

22. A method for calculating pulmonary vascular resistance (PVR) of a subject, without directly measuring pulmonary capillary wedge pressure, the method comprising the steps of:

determining the compliance C of pulmonary artery of the subject through a procedure that includes measuring blood pressure;

measuring pulmonary artery pressure (PAP1) of the subject at time t1;

measuring pulmonary artery pressure (PAP2) of the subject at time t2; and

calculating PVR according to an equation PVR=(t2-t1)/(C×

ln(PAP1/PAP2)).

23. The method of claim 22 in which the procedure for determining C comprises the steps of:

inserting a displacement balloon into the vessel, the displacement balloon being connected to a first opening of a tube having at least first and second openings, the second being connected to an adjustable pressure source;

changing the pressure of the adjustable pressure source so as to change volume of the displacement balloon by a predetermined amount;

sensing blood pressure in the vessel at a position near the displacement balloon;

determining change in blood pressure caused by the change in volume of the displacement balloon, and determining the compliance through an equation that includes the change in volume and the change in blood pressure.

24. A method for calculating systemic vascular resistance (SVR) of a subject, without directly measuring pulmonary capillary wedge pressure, the method comprising the steps of:

calculating pulmonary vascular resistance (PVR) of the subject;

determining mean pulmonary artery pressure (PAP) of the subject;

calculating cardiac output (CO) of the subject;

determining mean arterial pressure (AOP) of the subject;

calculating the pulmonary capillary wedge pressure (PCW) according to an equation PCW=(PVR×

CO)/PAP; and

calculating the systemic vascular resistance of the subject according to an equation SVR=(AOP×

PCW)/CO; and

in which the PVR is calculated according to a method including the

determining compliance of the subject through a procedure that includes measuring blood pressure;

measuring pulmonary artery pressure (PAP1) of the subject at time t1;

measuring pulmonary artery pressure (PAP2) of the subject at time t2; and

calculating PVR according to an equation PVR=(t2-t1)/(C×

ln(PAP1/PAP2)).

25. A method for calculating systemic vascular resistance (SVR) of a subject, the method comprising the steps of:

calculating pulmonary vascular resistance (PVR) of the subject;

determining mean arterial pressure (AOP) of the subject;

determining mean pulmonary artery pressure (PAP) of the subject;

calculating the SVR of the subject according to an equation SVR=AOP×

PVR/PAP; and

in which the PVR is calculated according to a method including the steps of;

determining compliance of the subject through a procedure that includes measuring blood pressure;

measuring pulmonary artery pressure (PAP1) of the subject at time t1;

measuring pulmonary artery pressure (PAP2) of the subject at time t2; and

calculating PVR according to an equation PVR=(t2-t1)/(C×

ln(PAP1/PAP2)).

26. A system for determining compliance of a vessel, the system comprising:

a catheter that is insertable into the vessel;

a displacement balloon positioned adjacent to the catheter;

a tube having at least first and second openings, the first opening being connected to the displacement balloon;

an adjustable pressure source connected to the second opening of the tube that selectively changes volume of the displacement balloon by a predetermined amount, thereby changing volume of the vessel by essentially the predetermined amount;

pressure detecting means for measuring blood pressure in the vessel at a position near the displacement balloon and generating a pressure signal indicative of the measured blood pressure; and

processing means for receiving the pressure signal, determining change in blood pressure caused by the change in volume of the displacement balloon, and determining the compliance based on the change in volume and the change in blood pressure.