Method of blood flow measurement in arterio-venous hemodialysis shunts by indicator dilution

• US 6,746,408 B2
• Filed: 05/29/2001
• Issued: 06/08/2004
• Est. Priority Date: 05/29/2001
• Status: Active Grant

• Current Assignee: Transonic Systems, Inc. (Measurement Innovations Corp.)
• Original Assignee: Transonic Systems, Inc. (Measurement Innovations Corp.)
• Inventors: Drost, Cornelis J., Krivitski, Nikolai M.
• Primary Examiner(s): Bennett, Henry
• Assistant Examiner(s): WIEKER, AMANDA FLYNN
• Application Number:
  US09/867,102
• Publication Number:
  US 20020183632A1
• Time in Patent Office: 1,106 Days
• Field of Search: 600/505, 600/526, 600/504, 600/507, 600/309, 604/28-29, 604/31, 604/503-4, 604/4.01, 604/5.01, 604/6.16, 604/7, 604/8, 73/616.4, 73/61
• US Class Current: 600/505
• CPC Class Codes: A61B 5/0275 using tracers, e.g. dye dilution
• CPC Class Codes: A61M 1/3656 Monitoring patency or flow at connection sites; Detecting disconnections
• CPC Class Codes: A61M 1/3663 Flow rate transducers; Flow integrators

Abstract

The present invention provides a method for measuring the blood flow rate within an A-V shunt via indicator dilution techniques. Unknown flow resistance within the A-V shunt are addressed by adjusting a measured flow rate to provide a flow rate within a predetermined margin of error. The calculated flow rate can be rejected based upon flow conditions of the introduced indicator. Different indicator introduction rates can be used to enhance accuracy of the measured flow. The indicator flow path can include a flow restrictor to limit the flow rate of the indicator to below a predetermined value.

Claims

1. In a method of calculating an initial blood flow rate in an arterio-venous shunt from an introduced indicator to the initial blood flow, the improvement comprising:

(a) reducing a measured flow rate in the arterio-venous shunt by a portion of a flow rate of the introduced indicator.

2. The method of claim 1, further comprising calculating the introduced indicator flow rate from a blood dilution curve and a known volume of the introduced indicator.

3. The method of claim 2, further comprising basing the introduced indicator flow rate on a width of a time versus blood parameter curve.

4. The method of claim 1, further comprising employing a thermal indicator as an introduced indicator.

5. The method of claim 4, further comprising calculating the introduced indicator flow rate from an injection dilution curve of an injection temperature sensor.

6. The method of claim 1, further comprising basing the value of the portion on the measured flow rate.

7. The method of claim 1, further comprising relating the value of the portion to a shunt flow rate-dependent fraction of the introduced indicator flow rate.

8. The method of claim 1, further comprising setting the value of the portion at 50% of the introduced indicator flow rate.

9. The method of claim 1, further comprising setting the value of the portion between 40 percent and 60 percent of the introduced indicator flow rate.

10. The method of claim 1, further comprising rejecting a calculation of an initial blood flow rate in response to an injection time greater than a predetermined time.

11. The method of claim 1, further comprising rejecting a calculation of an initial blood flow rate in response to an injection time less than a predetermined time.

12. The method of claim 1, further comprising rejecting a calculation of an initial blood flow rate in response to the introduced indicator flow rate being greater than a predetermined value.

13. The method of claim 1, further comprising rejecting a calculation of an initial blood flow rate in response to the introduced indicator flow rate being less than a predetermined value.

14. The method of claim 1, further comprising reducing the measured flow rate by less than 75% of the introduced indicator flow rate.

15. The method of claim 1, further comprising reducing the measured flow rate by 50% of the introduced indicator flow rate.

16. The method of claim 1, further comprising reducing the measured flow rate by 25% of the introduced indicator flow rate.

17. The method of claim 1, further comprising providing a second introduced indicator flow rate into the shunt.

18. The method of claim 17, further comprising determining a second measured flow rate corresponding to the second introduced indicator flow rate.

19. The method of claim 18, further comprising calculating an initial blood flow in response to the measured flow rate, the second measured flow rate, the introduced indicator flow rate and the second introduced indicator flow rate.

20. The method of claim 18, further comprising calculating an initial blood flow corresponding to the measured flow rate, the second measured flow rate, the introduced indicator flow rate and the second introduced indicator flow rate.

21. A method of adjusting a measured blood flow rate in an arterio-venous shunt by introducing a thermodilution indicator at a given flow rate into the shunt, the method comprising:

(a) subtracting a percentage of the given flow rate from the measured blood flow rate.

22. The method of claim 21, wherein subtracting a percentage of the given flow rate includes subtracting between 20 percent and 80 percent of the given flow rate.

23. In a method of determining an initial flow rate in a vessel by an introduced dilution indicator to the initial flow, the improvement comprising:

(a) reducing a measured flow rate in the vessel by a portion of a flow rate of the introduced dilution indicator.

24. The method of claim 23, further comprising rejecting the determination of an initial flow rate in response to an injection time greater than a predetermined time.

25. The method of claim 23, further comprising rejecting the determination of an initial flow rate in response to an injection time less than a predetermined time.

26. The method of claim 23, further comprising rejecting the determination of an initial flow rate in response to the introduced indicator flow rate being greater than a predetermined value.

27. The method of claim 23, further comprising rejecting the determination of an initial flow rate in response to the introduced indicator flow rate being less than a predetermined value.

28. A method of adjusting a measured flow rate in a vessel, the measured flow rate measured from introducing an indicator at a given flow rate into the vessel, the method comprising:

(a) subtracting a percentage of the given flow rate from the measured flow rate.

29. The method of claim 28, wherein subtracting a percentage of the given flow rate includes subtracting between 20 percent and 80 percent of the given flow rate.