Cardiac output and mixed venous oxygen content measurements by a tracer bolus method: theory

Author:

Clark Justin S.1,Lin Yuxiang J.1,Criddle Michael J.1,Cutillo Antonio G.1,Bigler Adelbert H.1,Farr Fred L.1,Renzetti Attilio D.1

Affiliation:

1. Department of Biomedical Engineering and Medical Physics, LDS Hospital, Salt Lake City 84103; and Department of Medical Informatics, Division of Respiratory, Critical Care and Occupational (Pulmonary) Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84132

Abstract

Clark, Justin S., Yuxiang J. Lin, Michael J. Criddle, Antonio G. Cutillo, Adelbert H. Bigler, Fred L. Farr, and Attilio D. Renzetti, Jr. Cardiac output and mixed venous oxygen content measurements by a tracer bolus method: theory. J. Appl. Physiol. 83(3): 884–896, 1997.—We present a bolus method of inert-gas delivery to the lungs that facilitates application of multiple inert gases and the multiple inert-gas-exchange technique (MIGET) model to noninvasive measurements of cardiac output (CO) and central mixed venous oxygen content[Formula: see text]Reduction in recirculation error is made possible by 1) replacement of sinusoidal input functions with impulse inputs and 2) replacement of steady-state analyses with transient analyses. Recirculation error reduction increases the inert-gas selection to include common gases without unusually high (and difficult to find) tissue-to-blood partition coefficients for maximizing the systemic filtering efficiency. This paper also presents a practical method for determining the recirculation contributions to inert expired profiles in animals and determining their specific contributions to errors in the calculations of CO and[Formula: see text] from simulations applied to published ventilation-perfusion ratio (V˙/Q˙) profiles. Recirculation errors from common gases were found to be reducible to the order of 5% or less for both CO and[Formula: see text] whereas simulation studies indicate that measurement bias contributions from recirculation, V˙/Q˙ mismatch, and the V˙/Q˙ extraction process can be limited to 15% for subjects with severeV˙/Q˙ mismatch and high inspired oxygen fraction levels. These studies demonstrate a decreasing influence of V˙/Q˙ mismatch on parameter extraction bias as the number of inert gases are increased. However, the influence of measurement uncertainty on parameter extraction error limits improvement to six gases.

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. MIGET: Practical Aspects;The Multiple Inert Gas Elimination Technique (MIGET);2017

2. Noninvasive estimation of mixed venous oxygen content;The Journal of Physical Fitness and Sports Medicine;2014

3. Cardiac output and mixed venous O2 content measurements by a tracer bolus method: animal validation study;Journal of Applied Physiology;1998-08-01

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