Apparatus and method for non-invasively measuring cardiac output

• US 6,648,831 B2
• Filed: 01/23/2001
• Issued: 11/18/2003
• Est. Priority Date: 12/19/1996
• Status: Expired due to Term

• Current Assignee: RIC INVESTMENTS LLC (Koninklijke Philips N.V.)
• Original Assignee: Novametrix Medical Systems, Inc. (Dixtal Medical, Inc.)
• Inventors: Westenskow, Dwayne, Orr, Joseph A., Jaffe, Michael B., Kofoed, Scott A.
• Primary Examiner(s): Nasser, Robert L.
• Application Number:
  US09/767,363
• Publication Number:
  US 20010031928A1
• Time in Patent Office: 1,029 Days
• Field of Search: 600/532, 600/526, 73/233, 422/84
• US Class Current: 600/526
• 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 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61M 16/0045 Means for re-breathing exhaled gases, e.g. for hyperventilation treatment
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: G01N 33/004 CO or CO2
• CPC Class Codes: Y02A 50/20 Air quality improvement or preservation, e.g. vehicle emission control or emission reduction by using catalytic converters

Abstract

Apparatus and methods for non-invasively determining cardiac output using partial re-breathing techniques are disclosed in which the apparatus is constructed with an instantaneously adjustable deadspace for accommodating differences in breathing capacities of various patients. The apparatus is constructed of inexpensive elements, including a single two-way valve which renders the apparatus very simple to use and inexpensive so that the unit may be readily disposable. The method of the invention provides a novel means of estimating cardiac output based on alveolar CO₂ values rather than end-tidal CO₂ values as previously practiced. A program for calculating cardiac output is also disclosed.

Claims

1. A method for noninvasively determining at least one of a cardiac output and a pulmonary capillary blood flow of a patient, comprising:

determining a change in carbon dioxide elimination of the patient between carbon dioxide elimination of the patient during normal breathing and carbon dioxide elimination of the patient during re-breathing;

determining a change in partial pressure of end-tidal carbon dioxide of the patient between partial pressure of end tidal carbon dioxide of the patient during said normal breathing and partial pressure of end tidal carbon dioxide of the patient during said re-breathing; and

compensating for functional residual capacity in lungs of the patient.

2. The method of claim 1, wherein said compensating comprises accounting for eliminated carbon dioxide not exhaled from the airway of the patient.

3. The method of claim 2, wherein said accounting comprises modifying at least one of said carbon dioxide elimination during said normal breathing and said carbon dioxide elimination during said re-breathing.

4. The method of claim 3, wherein said modifying comprises adding a product of said functional residual capacity and a partial pressure of end tidal carbon dioxide to carbon dioxide elimination.

5. The method of claim 1, further comprising estimating said functional residual capacity as a function of body weight of the patient, said estimating including accounting for airway and apparatus deadspace.

6. The method of claim 1, further comprising:

dividing said change in carbon dioxide elimination by a product of a slope of the carbon dioxide

dissociation curve and said change in partial pressure of end tidal carbon dioxide.

7. The method of claim 1, further comprising measuring carbon dioxide elimination and partial pressure of end tidal carbon dioxide over a plurality of breaths.

8. A method for estimating the cardiac output of an individual, comprising:

determining a carbon dioxide elimination (V_CO2) of the individual for a before re-breathing period and for a during/re-breathing period;

estimating a partial pressure of carbon dioxide in alveolar blood (PACO₂) of the individual for said before re-breathing period and for said during re-breathing period;

converting each estimation of said partial pressure of carbon dioxide in alveolar blood to a carbon dioxide content (C_CO2);

calculating a carbon dioxide elimination difference between said carbon dioxide elimination of said before rebreathing period and said carbon dioxide elimination of said during re-breathing period;

calculating a carbon dioxide content difference between said carbon dioxide content of said before re-breathing period and said carbon dioxide content of said during re-breathing period; and

dividing said carbon dioxide elimination difference by said carbon dioxide content difference.