CA2407579A1 - Calibration of a doppler velocimeter for stroke volume determination - Google Patents

Calibration of a doppler velocimeter for stroke volume determination Download PDF

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Publication number
CA2407579A1
CA2407579A1 CA002407579A CA2407579A CA2407579A1 CA 2407579 A1 CA2407579 A1 CA 2407579A1 CA 002407579 A CA002407579 A CA 002407579A CA 2407579 A CA2407579 A CA 2407579A CA 2407579 A1 CA2407579 A1 CA 2407579A1
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Prior art keywords
catheter
stroke volume
doppler
subject
cal
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CA002407579A
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French (fr)
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CA2407579C (en
Inventor
Markus J. Osypka
Donald P. Bernstein
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0538—Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—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
    • A61B5/026—Measuring blood flow
    • A61B5/029—Measuring or recording blood output from the heart, e.g. minute volume
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—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
    • A61B5/026—Measuring blood flow
    • A61B5/0295—Measuring blood flow using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0535—Impedance plethysmography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222—Evaluating particular parts, e.g. particular organs
    • A61B5/4233—Evaluating particular parts, e.g. particular organs oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters

Abstract

Doppler Velocimetry is a widely used method for estimating stroke volume (SV). The accuracy and reliability of its measurement however, is dependant on a) the correct assessment of the aortic valve cross-sectional area (CSA), and b) the maximal systolic velocity integral (SVI). The invention avoids the conventional assessment of aortic valve CSA by using a calibration method: a reference stroke volume SV REF IS determined by a method different from Doppler velocimetry, e.g. by thoracic electrical bioimpedance (TEB), or thoracic electrical bioadmittance, measured via surface thorax electrodes (transthoracic approach) or via electrodes located directly on an esophageal catheter/probe (esophageal approach). In the latter case, if esophageal Doppler velocimetry is used, the same catheter can be used for the placement of the electrodes and for an ultrasound transducer. In the case of esophageal Doppler velocimetry, an additional benefit of the invention is that the Doppler catheter/probe does not need to be aimed precisely at the site of maximum flow amplitude, as long as a stable catheter / probe location is maintained within the esophagus.

Claims (19)

1. A method of monitoring the stroke volume (SV) of a subject's heart at different time periods, comprising the steps of:
determining a reference stroke volume (SV REF) of the subject's heart by a first method different from Doppler velocimetry in a first time period;
simultaneously determining a reference systolic velocity integral (SVI CAL) by Doppler velocimetry;
calculating a constant k CAL, wherein k CAL = SV REF/SVI CAL:

determining a systolic velocity integral (SVI) at later time periods by Doppler velocimetry; and determining the stroke volume (SV) at said later periods by setting SV = k CAL
SVI.
2. The method of claim 1, wherein said first method uses one of the group of transthoracic electrical impedance measurements and transthoracic electrical bioadmittance measurements.
3. The method of claim 1, wherein said first method uses one of the group of esophageal electrical bioimpedance measurements and esophageal electrical bioadmittance measurements.
4. The method of claim 1, wherein esophageal Doppler velocimetry is used.
5. The method of claim 4, wherein, prior to determining said reference stroke volume (SV REF) and said reference systolic velocity integral (SVI CAL), a) a catheter comprising a device for performing Doppler velocimetry by obtaining Doppler signals is inserted into the subject's esophagus, b) said catheter is rotated until substantially maximal Doppler signal strength is obtained, and c) said catheter is fixed such that it can no longer be rotated.
6. The method of claim 4, wherein a catheter comprising a device for performing Doppler velocimetry is inserted into the subject's esophagus, and wherein it is attempted to hold the catheter fixed starting at least from said determination of said reference stroke volume (SV REF) and said reference systolic velocity integral (SVI CAL), and wherein after each movement of said catheter, despite said attempt to hold the catheter fixed, said reference stroke volume (SV REF) and said reference systolic velocity integral (SVI CAL) are newly determined and said constant k CAL is newly calculated, and wherein said newly calculated k CAL is used for the determination of the stroke volume (SV) until a new movement of said catheter occurs.
7. The method of claim 1, wherein during said Doppler velocimetry, a transducer is applied to the suprasternal acoustic window.
8. A method of monitoring the cardiac output (CO) of a subject's heart, comprising:
determining the stroke volume (SV) of the subject's heart by using the method according to claim 1;
determining the heart rate (HR) of the subject's heart; and calculating the cardiac output as, CO = SV .cndot. HR.
9. The method according to claim 8, wherein the heart rate (HR) is determined by using an electrocardiogram.
10. A system for monitoring the stroke volume (SV) of a subject's heart at different times, comprising:
a reference device for determining a reference stroke volume (SVREF) by using a first method different from Doppler velocimetry;
a Doppler velocimeter for determining reference systolic velocity integral (SVIREF~
SVI) at different times; and a device for calculating.
11. The system of claim 10, further comprising a controller for switching between:

a) a calibration mode in which said reference device and said Doppler velocimeter are activated, and b) a measurement mode in which only said Doppler velocimeter is activated.
12. An apparatus for monitoring the stroke volume (SV) of a subject's heart at different times, comprising:

a thoracic impedance measuring unit, including:
an alternating current (AC) source connected to two ports for attaching electrodes, and a voltmeter connected to two ports for attaching electrodes;
a Doppler velocimeter unit including a controller for controlling an ultrasound emitter and a signal receiving device for obtaining signals from an ultrasound receiver;
and a processing unit connected to said thoracic impedance measuring unit and said Doppler velocimeter unit.
13. The apparatus of claim 12, further comprising an interface for inputting data into said processing unit.
14. The apparatus of claim 12, further comprising a display.
15. A system for monitoring the stroke volume (SV) of a subject's heart, comprising:
the apparatus of claim 12; and a catheter which is adapted to be inserted into the subject's esophagus, wherein an ultrasound transducer is mounted on said catheter, said transducer being electrically connected to said Doppler velocimetry unit of said apparatus.
16. The system of claim 15, wherein four electrodes are mounted in two pairs on said catheter and wherein a first electrode of each pair is electrically connected to said alternating current (AC) source of said apparatus and a second electrode of each pair is electrically connected to said voltmeter of said apparatus, and wherein said second electrodes are located closer to each other than said first electrodes.
17. An apparatus adapted to be inserted into a subject's esophagus, comprising:
a catheter;
at least two electrodes on the catheter; and an ultrasound transducer for Doppler velocimetry on the chatheter.
18. The catheter of claim 17, wherein said transducer is placed in the center of the electrodes.
19. The catheter of claim 18, wherein four electrodes are mounted on the catheter in a pairwise arrangement, one of said pairs being placed nearer to the transducer than the other pair.
CA2407579A 2001-10-11 2002-10-10 Calibration of a doppler velocimeter for stroke volume determination Expired - Lifetime CA2407579C (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US32863001P 2001-10-11 2001-10-11
US60/328,630 2001-10-11
US10/268,120 US7186219B2 (en) 2001-10-11 2002-10-10 Calibration of a doppler velocimeter for stroke volume determination
USUNKNOWN 2006-12-06

Publications (2)

Publication Number Publication Date
CA2407579A1 true CA2407579A1 (en) 2003-04-11
CA2407579C CA2407579C (en) 2012-12-11

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CA2407579A Expired - Lifetime CA2407579C (en) 2001-10-11 2002-10-10 Calibration of a doppler velocimeter for stroke volume determination

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US (1) US7186219B2 (en)
EP (1) EP1302166B8 (en)
AT (1) ATE303098T1 (en)
CA (1) CA2407579C (en)
DE (1) DE60205838T2 (en)

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US7822470B2 (en) * 2001-10-11 2010-10-26 Osypka Medical Gmbh Method for determining the left-ventricular ejection time TLVE of a heart of a subject
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Also Published As

Publication number Publication date
CA2407579C (en) 2012-12-11
EP1302166B1 (en) 2005-08-31
EP1302166B8 (en) 2005-11-02
ATE303098T1 (en) 2005-09-15
DE60205838T2 (en) 2006-07-13
US20030163056A1 (en) 2003-08-28
DE60205838D1 (en) 2005-10-06
US7186219B2 (en) 2007-03-06
EP1302166A1 (en) 2003-04-16

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