Flow Estimation by Indicator Dilution (Bolus Injection)

Abstract

Indicator dilution techniques used for the estimation of flow (F), mean transit time (t), dispersion (σ), and mean transit time volume (V) in the circulation are subject to error when (1) flow is not steady and (2) concentrations are obtained by sampling at a constant rate (time averaging) rather than at rates proportional to the instantaneous flow past the sampling site (volume averaging). Using a simple descriptive model for indicator transport, the effects of simulated aortic flow or of sinusoidal flow of widely variable frequency were assessed. Errors in estimates of F, t, σ, and V are greater with bolus injections than with constant-rate injections. Errors are roughly proportional to the amplitude of variation in flow. They are maximal when the period of flow fluctuation is similar to the passage time of the dilution curve, which, for the human central circulation, is about the time for one respiratory cycle. With sinusoidal flow between 50% and 150% of the mean flow, errors were at worst up to 60% in F, 30% in t, 50% in σ, and 70% in V, with a bimodal distribution. Errors are minimal at cardiac frequencies. The troublesome lower frequencies can be avoided. Preliminary tests of a method for converting time- to volume-averaged concentrations gave encouraging results.