Method and apparatus for determining cardiac output or total peripheral resistance

• US 6,485,431 B1
• Filed: 11/16/2000
• Issued: 11/26/2002
• Est. Priority Date: 11/24/1999
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Duncan Cambpell Patents Pty., Ltd.
• Inventors: Campbell, Duncan
• Primary Examiner(s): Nasser, Robert L.
• Application Number:
  US09/714,721
• Time in Patent Office: 740 Days
• Field of Search: 600/485, 600/500, 600/504, 600/505, 600/526
• US Class Current: 600/526
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence

Abstract

A method and apparatus determines continuously mean cardiac output by measuring the arterial pressure e.g. at a finger and calculating therefrom the mean arterial pressure and the time constant of the arterial system (in diastole). Compliance values are provided from a table. Mean cardiac output is then the product of mean arterial pressure and compliance divided by the time constant. Changes in cardiac output can be used for diagnostic purposes. A pressure cuff or pressure tonometer can be used to measure the arterial pressure with a microcomputer providing the necessary calculations.

Claims

1. A method for deriving cardiac output in a patient comprising the steps of:

measuring continuously the arterial pressure at a point within the cardiovascular system to derive an arterial pressure waveform;

determining the mean arterial pressure from said arterial pressure waveform;

determining the compliance of the arterial system for the patient;

determining the time constant of the arterial system from the arterial pressure waveform and deriving the mean cardiac output as the product of the mean arterial pressure and compliance divided by said time constant.

2. A method for deriving a cardiac output in a patient as claimed in claim 1 wherein said step of determining compliance is determined from a table expressing compliance as a function of weight, height, age and sex of the patient.

3. A method for deriving cardiac output in a patient as claimed in claim 2 wherein said time constant is the rate of change of the arterial pressure waveform substantially after the dicrotic notch.

4. A method for deriving cardiac output in a patient as claimed in claim 3 wherein said rate of change is the slope of the arterial pressure waveform after the dicrotic notch extrapolated to zero arterial pressure.

5. A method for deriving cardiac output in a patient as claimed in claim 4 further including the step of measuring heart rate and calculating stroke volume by dividing said mean cardiac output by said heart rate.

6. A method for deriving cardiac output in a patient as claimed in claim 5 wherein said step of measuring heart rate includes measuring the pulse period of said arterial pressure waveform and taking the inverse thereof.

7. A method for deriving cardiac output in a patient as claimed in claim 6 wherein said step of measuring continuously the arterial pressure includes using a finger cuff transducer.

8. A method for deriving cardiac output in a patient as claimed in claim 6 wherein said step of measuring continuously the arterial pressure includes using a pressure tonometer.

9. A method for deriving cardiac output in a patient as claimed in claim 6 wherein said step of continuously measuring the arterial pressure includes using an intra-arterial catheter and pressure transducer.

10. A method for deriving cardiac output in a patient as claimed in claim 1 wherein said step of determining compliance is determined by measuring pulse wave velocity.

11. A method for deriving cardiac output in a patient as claimed in claim 10 wherein said step of measuring continuously the arterial pressure includes using a finger cuff transducer.

12. A method for deriving cardiac output in a patient as claimed in claim 10 wherein said step of continuously measuring the arterial pressure includes using a pressure tonometer.

13. A method for deriving cardiac output in a patient as claimed in claim 10 wherein said step of continuously measuring the arterial pressure includes using an intra-arterial catheter and pressure transducer.

14. An apparatus for deriving cardiac output in a patient including means for continuously measuring arterial pressure at a point within the cardiovascular system;

means for processing said measured arterial pressure including means for calculating the mean arterial pressure;

means for inputting compliance values; and

means for measuring the time constant of the arterial system from said measured arterial pressure; and

means for calculating cardiac output as the product of mean arterial pressure and compliance divided by said time constant, and further including means for displaying at least said arterial pressure and said cardiac output.

15. An apparatus for deriving cardiac output in a patient as claimed in claim 14 wherein said means for calculating said mean arterial pressure and said cardiac output includes a digital computer.

16. An apparatus for deriving cardiac output in a patient as claimed in claim 15 wherein said compliance values are stored in a memory device connected to said digital computer.

17. An apparatus for deriving cardiac output in a patient as claimed in claim 16 wherein said means for displaying includes means for displaying said arterial pressure and said cardiac output remotely from said means for continuously measuring said arterial pressure.

18. An apparatus for deriving cardiac output in a patient as claimed in claim 17 further including means for acoustically determining aortic valve closure.

19. An apparatus for deriving cardiac output in a patient as claimed in claim 18 further including means for measuring the electrical activity of the heart.

20. An apparatus for deriving cardiac output in a patient as claimed in claim 19 wherein said means for acoustically determining aortic valve closure and said means for measuring the electrical activity of the heart include respectively a microphone and an electrocardiograph.

21. An apparatus for deriving cardiac output in a patient as claimed in claim 15 wherein said means for continuously measuring arterial pressure at a point within the cardiovascular system includes a finger cuff transducer.

22. An apparatus for deriving cardiac output in a patient as claimed in claim 15 wherein said means for continuously measuring arterial pressure at a point within the cardiovascular system includes a pressure tonometer.

23. An apparatus for deriving cardiac output in a patient as claimed in claim 15 wherein said means for continuously measuring arterial pressure at a point within the cardiovascular system includes an intra-arterial catheter and pressure transducer arrangement.

24. A method for deriving cardiac output comprising the steps of:

measuring continuously a patient'"'"'s arterial pressure at a point within the patient'"'"'s cardiovascular system for deriving an arterial pressure waveform;

determining compliance of the patient'"'"'s arterial system;

determining a time constant of the patient'"'"'s arterial system from the arterial pressure waveform and deriving peripheral resistance as said time constant divided by said compliance; and

,

determining mean arterial pressure from said arterial pressure waveform and deriving mean cardiac output as a product of said peripheral resistance and said mean arterial pressure.

25. A method for deriving cardiac output comprising the steps of:

measuring continuously a patient'"'"'s arterial pressure at a point within the patient'"'"'s cardiovascular system for deriving an arterial pressure waveform;

determining the compliance of the patient'"'"'s arterial system; and

,

determining a time constant of the patient'"'"'s arterial system from the arterial pressure waveform and deriving peripheral resistance as said time constant divided by said compliance.