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Sample records for measure cardiac output

  1. Methods in pharmacology: measurement of cardiac output

    PubMed Central

    Geerts, Bart F; Aarts, Leon P; Jansen, Jos R

    2011-01-01

    Many methods of cardiac output measurement have been developed, but the number of methods useful for human pharmacological studies is limited. The ‘holy grail’ for the measurement of cardiac output would be a method that is accurate, precise, operator independent, fast responding, non-invasive, continuous, easy to use, cheap and safe. This method does not exist today. In this review on cardiac output methods used in pharmacology, the Fick principle, indicator dilution techniques, arterial pulse contour analysis, ultrasound and bio-impedance are reviewed. PMID:21284692

  2. Issues in methods and measurement of thermodilution cardiac output.

    PubMed

    Sommers, M S; Woods, S L; Courtade, M A

    1993-01-01

    Criterion-related validity of the thermodilution cardiac output technique for cardiac output measurement has to have a high correlation (r = .91 to .98) with the direct Fick method, the gold standard of cardiac output measurement. Issues that can affect validity of the measurements include the position of the pulmonary artery catheter, the rate of injection of the indicator solution, the volume and temperature of the injectate, the timing of the injection of indicator solution during the respiratory cycle, the position of the subject, and the presence of concomitant infusions. Variation in measurement can be limited by considering the delivery system for the indicator solution, by recording time-temperature cardiac output curves, and by considering normal biologic variations. PMID:8337161

  3. Noninvasive cardiac output measurements in patients with pulmonary hypertension.

    PubMed

    Rich, Jonathan D; Archer, Stephen L; Rich, Stuart

    2013-07-01

    Pulmonary hypertension (PH) is characterised by a progressive decline in cardiac output (CO) and right heart failure. NICOM® (noninvasive cardiac output monitor) is a bioreactance-based technology that has been broadly validated, but its specific application in right heart failure and PH is unknown. Cardiac catheterisation was performed in 50 consecutive patients with PH. CO measurements were performed using three different methods (thermodilution, Fick and NICOM) at baseline and after vasodilator challenge. We compared the precision (coefficient of variation) and accuracy of NICOM compared to thermodilution and Fick. The mean CO (L·min(-1)) at baseline as measured by the three methods was 4.73±1.15 (NICOM), 5.69±1.74 (thermodilution) and 4.84±1.39 (Fick). CO measured by NICOM was more precise than by thermodilution (3.5±0.3% versus 9.6±6.1%, p<0.001). Bland-Altman analyses comparing NICOM to thermodilution and Fick revealed bias and 95% limits of agreement that were comparable to those comparing Fick to thermodilution. All three CO methods detected an increase in CO in response to vasodilator challenge. CO measured via NICOM is precise and reliably measures CO at rest and changes in CO with vasodilator challenge in patients with PH. NICOM may allow for the noninvasive haemodynamic assessment of patients with PH and their response to therapy. PMID:23100501

  4. Measurement of cardiac output in children by bioreactance.

    PubMed

    Ballestero, Yolanda; López-Herce, Jesús; Urbano, Javier; Solana, Maria José; Botrán, Marta; Bellón, Jose M; Carrillo, Angel

    2011-04-01

    The objective of this study was to evaluate a new bioreactance method for noninvasive cardiac output (CO) measurement (NICOM) in children. Ten patients between 1 and 144 months of age and with no hemodynamic disturbances were studied. Using bioreactance, heart rate (HR), mean arterial pressure (MAP), and cardiac index (CI) measurements were made every 6-8 h. CI was 2.4 ± 1.03 l/min/1.73 m(2) (range 1-4.9 l/min/1.73 m(2)); There were significant correlations between CI and age (r = 0.50, P = 0.003), weight (r = 0.66, P < 0.001), and MAP (r = 0.369, P = 0.037). Significant differences in CI (P < 0.001) were detected between children weighing <10 kg (1.9 ± 0.73 l/min/1.73 m(2); range 1-3.2), 10-20 kg (2.07 ± 0.7 l/min/1.73 m(2); range 1-3.6), and >20 kg (3.7 ± 0.8 l/min/1.73 m(2); range 2.4-4.9). We conclude that the CI measured by bioreactance in children varies with the age and weight of the patients and is lower than the normal range in a large percentage of measurements. These data suggest that this method is not useful for evaluating CI in small children. PMID:21318463

  5. Measurement of cardiac output by use of noninvasively measured transient hemodilution curves with photoacoustic technology

    PubMed Central

    Kang, Dongyel; Huang, Qiaojian; Li, Youzhi

    2014-01-01

    We present the theoretical basis and experimental verification for cardiac output measurements using noninvasively measured hemodilution curves afforded with an indicator dilution technique and the emerging photoacoustic technology. A photoacoustic system noninvasively tracks a transient hemodilution effect induced by a bolus of isotonic saline as an indicator. As a result, a photoacoustic indicator dilution curve is obtained, which allows to estimate cardiac output from the developed algorithm. The experiments with a porcine blood circulatory phantom system demonstrated the feasibility of this technology towards the development of a noninvasive cardiac output measurement system for patient monitoring. PMID:24877007

  6. Minimally invasive or noninvasive cardiac output measurement: an update.

    PubMed

    Sangkum, Lisa; Liu, Geoffrey L; Yu, Ling; Yan, Hong; Kaye, Alan D; Liu, Henry

    2016-06-01

    Although cardiac output (CO) by pulmonary artery catheterization (PAC) has been an important guideline in clinical management for more than four decades, some studies have questioned the clinical efficacy of CO in certain patient populations. Further, the use of CO by PAC has been linked to numerous complications including dysrhythmia, infection, rupture of pulmonary artery, injury to adjacent arteries, embolization, pulmonary infarction, cardiac valvular damage, pericardial effusion, and intracardiac catheter knotting. The use of PAC has been steadily declining over the past two decades. Minimally invasive and noninvasive CO monitoring have been studied in the past two decades with some evidence of efficacy. Several different devices based on pulse contour analysis are available currently, including the uncalibrated FloTrac/Vigileo system and the calibrated PiCCO and LiDCO systems. The pressure-recording analytical method (PRAM) system requires only an arterial line and is commercially available as the MostCare system. Transesophageal echocardiography (TEE) can measure CO by non-Doppler- or Doppler-based methods. The partial CO2 rebreathing technique, another method to measure CO, is marketed by Novametrix Medical Systems as the NICO system. Thoracic electrical bioimpedance (TEB) and electric bioreactance (EB) are totally noninvasive CO monitoring. Nexfin HD and the newer ClearSight systems are examples of noninvasive CO monitoring devices currently being marketed by Edwards Lifesciences. The developing focus in CO monitoring devices appears to be shifting to tissue perfusion and microcirculatory flow and aimed more at markers that indicate the effectiveness of circulatory and microcirculatory resuscitations. PMID:26961819

  7. Measurement of cardiac output from dynamic pulmonary circulation time CT

    SciTech Connect

    Yee, Seonghwan; Scalzetti, Ernest M.

    2014-06-15

    Purpose: To introduce a method of estimating cardiac output from the dynamic pulmonary circulation time CT that is primarily used to determine the optimal time window of CT pulmonary angiography (CTPA). Methods: Dynamic pulmonary circulation time CT series, acquired for eight patients, were retrospectively analyzed. The dynamic CT series was acquired, prior to the main CTPA, in cine mode (1 frame/s) for a single slice at the level of the main pulmonary artery covering the cross sections of ascending aorta (AA) and descending aorta (DA) during the infusion of iodinated contrast. The time series of contrast changes obtained for DA, which is the downstream of AA, was assumed to be related to the time series for AA by the convolution with a delay function. The delay time constant in the delay function, representing the average time interval between the cross sections of AA and DA, was determined by least square error fitting between the convoluted AA time series and the DA time series. The cardiac output was then calculated by dividing the volume of the aortic arch between the cross sections of AA and DA (estimated from the single slice CT image) by the average time interval, and multiplying the result by a correction factor. Results: The mean cardiac output value for the six patients was 5.11 (l/min) (with a standard deviation of 1.57 l/min), which is in good agreement with the literature value; the data for the other two patients were too noisy for processing. Conclusions: The dynamic single-slice pulmonary circulation time CT series also can be used to estimate cardiac output.

  8. The effect of incomplete acetylene washout on cardiac output measurement using open circuit acetylene uptake.

    PubMed

    Balouch, Jamal; Olfert, I Mark; Wagner, Peter D; Hopkins, Susan R

    2007-02-15

    The open circuit acetylene uptake method is a useful non-invasive means of measuring cardiac output. However, because of accumulation of inhaled acetylene in tissues, the cardiac output uptake is underestimated, if residual acetylene is not allowed to wash out completely in between measurements. We determined the effect of applying a correction factor that estimates mixed venous acetylene concentration from endtidal values to the calculation of cardiac output. This accounts for mixed venous acetylene present during measurements made before complete washout. Six healthy subjects performed steady-state exercise at approximately 30% and 60% of V(O2 max). Cardiac output measurements were made at each exercise intensity using the open circuit acetylene uptake method (inspired [acetylene] approximately 1%), with the first and last measurements having no detectible levels of acetylene in expired gas (reference measurement). Data were also obtained with immediate pre-measurement endtidal concentrations ranging from 3% to 15% of the inspired [acetylene], in random order in between. Oxygen consumption, carbon dioxide production and heart rate did not change significantly during testing at each exercise intensity. Reference cardiac output also did not change significantly and averaged 11.1+/-0.8 L/min at 30% of V(O2 max) and 16.5+/-2.0 L/min at 60% of V(O2 max). Uncorrected cardiac output measurements progressively underestimated cardiac output by 15% at the 3% of inspired endtidal [acetylene] and by over 50% at 15% [acetylene] (p<0.0001). However, when corrected for residual endtidal [acetylene], cardiac outputs were not significantly different from the reference measurements. The results of this study suggest that by accounting for residual endtidal acetylene in mixed venous blood, cardiac output can be accurately measured even when washout of acetylene is incomplete, allowing measurements as often as every 10-15 s. PMID:16714151

  9. Continuous cardiac output measurement - Aspects of Doppler frequency analysis

    NASA Technical Reports Server (NTRS)

    Mackay, R. S.; Hechtman, H. B.

    1975-01-01

    From the suprasternal notch blood flow velocity in the aorta can be measured non-invasively by a Doppler probe. Integration over systole after frequency analysis gives a measure of stroke volume if a separate diameter observation is incorporated. Frequency analysis by a zero crossing counter or by a set of parallel phaselock loops was less effective than a set of bandpass filters. Observations on dogs, baboons and humans before and after exercise or surgery suggest the indications to be useful. Application to judging heart failure by the effect of introducing a volume load is indicated. Changes in output also are measured in freely moving subjects.

  10. Comparison of impedance cardiography and dye dilution method for measuring cardiac output

    PubMed Central

    Spiering, W; van Es, P N; de Leeuw, P W

    1998-01-01

    Objective—To assess the degree of agreement between impedance cardiography, using the NCCOM3-R7 device, and the gold standard—the dye dilution method—both under basal conditions and after stimulation of cardiac output.
Patients—35 paired measurements in five healthy male volunteers.
Interventions—To obtain higher levels of cardiac output, cardiac performance was stimulated with a dopamine infusion.
Results—In 35 paired measurements, the mean of all the impedance values was higher than that of the dye dilution values, at 10.2 v 7.4 l/min (p < 0.0001). The mean discrepancy between the two methods was 3.3 l/min, and the mean bias −2.9 l/min, with limits of agreement of −9.0 and 3.2 l/min. A change in cardiac output could not adequately be predicted by the NCCOM3-R7. In 20 of 25 measurements obtained during continuous intravenous dopamine infusions there was a rise in dye dilution cardiac output (range 0.2 to 5.9 l/min). Neither the magnitude nor the direction of the change in dye dilution values corresponded with the change measured by impedance cardiography. The mean discrepancy here between the two methods was 1.8 l/min, and the mean bias −0.8 l/min, with limits of agreement of −4.9 and 3.3 l/min.
Conclusions—In healthy volunteers, impedance cardiography with NCCOM3-R7 is inadequate for assessing cardiac output when compared with the dye dilution method.

 Keywords: cardiac output;  impedance cardiography;  dye dilution PMID:9659188

  11. Measurement of cardiac output using improved chromatographic analysis of sulfur hexafluoride (SF6).

    PubMed

    Klocke, F J; Roberts, D L; Farhi, E R; Naughton, B J; Sekovski, B; Klocke, R A

    1977-06-01

    A constant current variable frequency pulsed electron capture detector has been incorporated into the gas chromatographic analysis of trace amounts of sulfur hexafluoride (SF6) in water and blood. The resulting system offers a broader effective operating range than more conventional electron capture units and has been utilized for measurements of cardiac output employing constant-rate infusion of dissolved SF6. The SF6 technique has been validated against direct volumetric measurements of cardiac output in a canine right-heart bypass preparation and used subsequently for rapidly repeated measurements in conscious animals and man. PMID:877454

  12. Investigations concerning the application of the cross-correlation method in cardiac output measurements

    PubMed Central

    2012-01-01

    Background In spite of numerous non-invasive examinations the “gold clinical standard” of cardiac output measurements is the invasive pulmonary artery catheterization by means of the Swan-Ganz catheter and the application of the thermodilution method to estimate the blood flow. The results obtained by means of thermodilution are sensitive to many physical and biological disturbances. The unreliability of this method amounts to 20-45% and depends on the given variant of the method. Therefore some other method, more accurate and resistant to disturbances, was looked for. This paper presents a new approach to cardiac output measurements, based on cross-correlation signal analysis. The goal of investigations was to verify experimentally the application of the cross-correlation method of cardiac output measurements. Results In 99.2% of the examined cases the extreme of the cross-correlation function was easy to be estimated by numerical algorithms. In 0,8% of the remaining cases (with a plateau region adjacent to the maximum point) numerical detection of the extreme was inaccurate. The typical unreliability of the investigated method amounted o 5.1% (9.8% in the worst case). Investigations performed on a physical model revealed that the unreliability of cardiac output measurements by means of the cross-correlation method is 3–5 times better than in the case of thermodilution. Conclusions The performed investigations and theoretical analysis have shown, that the cross-correlation method may be applied in cardiac output measurements. This kind of measurements seems to be more accurate and disturbance-resistant than clinically applied thermodilution. PMID:22607380

  13. Mathematics and the Heart: Understanding Cardiac Output

    ERIC Educational Resources Information Center

    Champanerkar, Jyoti

    2013-01-01

    This paper illustrates a biological application of the concepts of relative change and area under a curve, from mathematics. We study two biological measures "relative change in cardiac output" and "cardiac output", which are predictors of heart blockages and other related ailments. Cardiac output refers to the quantity of…

  14. Comparison of dynamic measurements of pulse contour with pulsed heat continuous cardiac output in postoperative cardiac surgical patients.

    PubMed

    Boyle, Martin; Lawrence, John; Belessis, Andrew; Murgo, Margherita; Shehabi, Yahya

    2007-02-01

    Cardiac output (CO) can be measured using bolus thermodilution via a pulmonary artery catheter (PAC) and as continuous cardiac output (CCO), using pulsed heat thermoditution. Pulse contour cardiac output (PCCO) measures continuous CO by analysis of the arterial waveform after calibration with thermodilution CO. The Pulsion Medical Systems (PiCCO system) achieves this by transpulmonary aortic thermodilution (TDtpa). There is uncertainty regarding the agreement between TDtpa, CCO, and PCCO CO measurements in situations of rapid haemodynamic changes. We studied the agreement of the measures by comparing digital recordings of cardiac index (CI) determined by PCCO and CCO (PCCI and CCI, respectively) made during periods of haemodynamic instability. After ethics committee approval we studied four post-coronary artery bypass graft patients, in the immediate postoperative period. Each patient had a 7.5F CCO catheter (Edwards Lifesciences) and a 5F, 20cm PCCO femoral artery catheter. Digital recordings were obtained for the first 12-18 postoperative hours. Six epochs of instability were identified in the first two to three postoperative hours, and at the commencement of inotropic or vasoactive drugs. Notable features, despite frequent PCCO calibrations, were the marked difference of PCCI compared to CCI. In contradistinction, they tracked very closely during a period of stability. Limitations of both methods were noted. Whilst PCCO responded to rapid change, it developed significant error during haemodynmamic instability and requires frequent recalibration. CCO on the other hand has a considerable time lag in responding to changes in CO. The way a monitor measures CO must be taken into account when using the data in clinical management. PMID:17424793

  15. Noninvasive photoacoustic measurement of the composite indicator dilution curve for cardiac output estimation

    PubMed Central

    Kang, DongYel; Huang, Qiaojian; Li, Youzhi

    2015-01-01

    Recently, the measurement of indicator dilution curves using a photoacoustic (PA) technology was reported, which showed promising results on the noninvasive estimation of cardiac output (CO) that is an important hemodynamic parameter useful in various clinical situations. However, in clinical practice, measuring PA indicator dilution curves from an arterial blood vessel requires an ultrasound transducer array capable of focusing on the targeted artery. This causes several challenges on the clinical translation of the PA indicator dilution method, such as high sensor cost and complexity. In this paper, we theoretically derived that a composite PA indicator dilution curve simultaneously measured from both arterial and venous blood vessels can be used to estimate CO correctly. The ex-vivo and in-vivo experimental results with a flat ultrasound transducer verified the developed theory. We believe this new concept would overcome the main challenges on the clinical translation of the noninvasive PA indicator dilution technology. PMID:25780743

  16. Automated non-invasive measurement of cardiac output: comparison of electrical bioimpedance and carbon dioxide rebreathing techniques.

    PubMed Central

    Smith, S A; Russell, A E; West, M J; Chalmers, J

    1988-01-01

    Two commercial automated, non-invasive systems for estimation of cardiac output were evaluated. Values of cardiac output obtained by electrical bioimpedance cardiography (BoMed NCCOM3 machine) were compared with values derived from an indirect Fick technique that uses carbon dioxide rebreathing (Gould 9000 IV system) during 103 simultaneous measurements made at rest in 19 randomly selected subjects and on exercise in 11 subjects. Cardiac output values obtained with impedance cardiography were significantly correlated with those measured by the indirect Fick method, although there was a wide scatter with over 73% of the readings lying outside the limits defined by the line of identity +/- 20%. This correlation was greatly reduced when stroke volume index was used instead of cardiac output. Indirect Fick results were linearly related to oxygen uptake both at rest and on exercise, while impedance cardiography results did not correlate with oxygen uptake. Impedance cardiography gave consistently lower results for cardiac output than indirect Fick at all levels of exercise. Both machines were easy to use and produced acceptable mean (SE) coefficients of variation (BoMed NCCOM3 7.7 (1.0)%, Gould 9000 IV 10.6 (1.4)%). Further validation is required before either of these machines can be recommended as an alternative to invasive monitoring in clinical practice. PMID:3128316

  17. Influence of electrode positioning on accuracy and reproducibility of electrical velocimetry cardiac output measurements.

    PubMed

    Trinkmann, Frederik; Berger, Manuel; Michels, Julia D; Doesch, Christina; Weiss, Christel; Schoenberg, Stefan O; Akin, Ibrahim; Borggrefe, Martin; Papavassiliu, Theano; Saur, Joachim

    2016-09-01

    Electrical velocimetry (EV) is one of the most recent adaptions of impedance cardiography. Previous studies yielded diverging results identifying several factors negatively influencing accuracy. Although electrode arrangement is suspected to be an influencing factor for impedance cardiography in general, no data for EV is available. We aimed to prospectively assess the influence of electrode position on the accuracy and reproducibility of cardiac output (CO) measurements obtained by EV. Two pairs of standard electrocardiographic electrodes were placed at predefined positions of the thorax in 81 patients. The inter-electrode gap was varied between either 5 or 15 cm by caudal movement of the lowest electrode. Measurements were averaged over 20 s and performed twice at each electrode position. Reference values were determined using cardiac magnetic resonance imaging (CMR). Mean bias was 1.2  ±  1.6 l min(-1) (percentage error 22  ±  28%) between COCMR and COEV at the 5 cm gap significantly improving to 0.5  ±  1.6 l min(-1) (8  ±  28%) when increasing the gap (p  <  0.0001). The mean difference between repeated measurements was 0.0  ±  0.3 l min(-1) for the 5 cm and 0.1  ±  0.3 l min(-1) for the 15 cm gap, respectively (p  =  0.3). The accuracy of EV can be significantly improved when increasing the lower inter-electrode gap still exceeding the Critchley and Critchley recommendations. Therefore, absolute values should not be used interchangeably in clinical routine. As the reproducibility was not negatively affected, serial hemodynamic measurements can be reliably acquired in stable patients when the electrode position remains unchanged. PMID:27480359

  18. [A dye densitometry analysis method for noninvasive measurement of cardiac output based on NIRS].

    PubMed

    Lu, Meng-Meng; Wang, Hong-Xuan; Liu, Guang-Da; Xin, Gui-Jie; Yu, Yong; Zha, Yu-Tong

    2013-12-01

    Currently, there exist technology problems in cardiac output (CO) parameter detection clinically, such as invasive and complex operation, as well as possibility of infection and death for patients. In order to solve these problems, a noninvasive and continuous method based on NIRS for CO detection was presented. In this way, the concentration changing of indocyanine green (ICG) dye in the patient's arterial blood was dynamically measured and analyzed, so that the CO could be noninvasively and continuously measured according to the characteristic parameters of dye densitometry curve. While the ICG dye was injected into the patient's body by the median cubital vein, block of photoelectric pulse dye densitometry measurement system as the lower machine acquired pulse wave data and uploaded the data to upper computer. In the scheme, two specialized light sources of LED at 940 and 805 nm were used to capture the signals of sufferer's fingertip pulse wave synchronously and successively. The CO value could then be successfully calculated through drawing complete ICG concentration variation of dye dilution and excretion process and computing mean transmission time (MTT) by upper computer. Compared with the "gold standard" method of thermodilution, the maximum relative error of this method was below 9. 76%, and the mean relative error was below 4. 39%. The result indicates that the method can be used as a kind of convenient operation, noninvasive and continuous solution for clinical CO measurement. PMID:24611365

  19. Quantification of mitral regurgitation by automated cardiac output measurement: experimental and clinical validation

    NASA Technical Reports Server (NTRS)

    Sun, J. P.; Yang, X. S.; Qin, J. X.; Greenberg, N. L.; Zhou, J.; Vazquez, C. J.; Griffin, B. P.; Stewart, W. J.; Thomas, J. D.

    1998-01-01

    OBJECTIVES: To develop and validate an automated noninvasive method to quantify mitral regurgitation. BACKGROUND: Automated cardiac output measurement (ACM), which integrates digital color Doppler velocities in space and in time, has been validated for the left ventricular (LV) outflow tract but has not been tested for the LV inflow tract or to assess mitral regurgitation (MR). METHODS: First, to validate ACM against a gold standard (ultrasonic flow meter), 8 dogs were studied at 40 different stages of cardiac output (CO). Second, to compare ACM to the LV outflow (ACMa) and inflow (ACMm) tracts, 50 normal volunteers without MR or aortic regurgitation (44+/-5 years, 31 male) were studied. Third, to compare ACM with the standard pulsed Doppler-two-dimensional echocardiographic (PD-2D) method for quantification of MR, 51 patients (61+/-14 years, 30 male) with MR were studied. RESULTS: In the canine studies, CO by ACM (1.32+/-0.3 liter/min, y) and flow meter (1.35+/-0.3 liter/min, x) showed good correlation (r=0.95, y=0.89x+0.11) and agreement (deltaCO(y-x)=0.03+/-0.08 [mean+/-SD] liter/min). In the normal subjects, CO measured by ACMm agreed with CO by ACMa (r=0.90, p < 0.0001, deltaCO=-0.09+/-0.42 liter/min), PD (r=0.87, p < 0.0001, deltaCO=0.12+/-0.49 liter/min) and 2D (r=0.84, p < 0.0001, deltaCO=-0.16+/-0.48 liter/min). In the patients, mitral regurgitant volume (MRV) by ACMm-ACMa agreed with PD-2D (r= 0.88, y=0.88x+6.6, p < 0.0001, deltaMRV=2.68+/-9.7 ml). CONCLUSIONS: We determined that ACM is a feasible new method for quantifying LV outflow and inflow volume to measure MRV and that ACM automatically performs calculations that are equivalent to more time-consuming Doppler and 2D measurements. Additionally, ACM should improve MR quantification in routine clinical practice.

  20. Flow-regulated extracorporeal arteriovenous tubing loop for cardiac output measurements by ultrasound velocity dilution: validation in post-cardiac surgery intensive care unit patients.

    PubMed

    Eremenko, Alexsandr A; Safarov, Perviz N

    2010-01-01

    Assessment of cardiac output (CO) is crucial in the management of the critically ill, especially in post cardiac surgery intensive care unit (ICU) patients. In this study, we validated CO measured by the novel ultrasound dilution (COUD) with those measured by pulmonary artery (PA) thermodilution (COTD) in 26 adult post cardiac surgery patients. For COUD, blood was circulated through an extracorporeal arteriovenous (AV) loop from the radial artery catheter to the introducer of PA catheter for 5-8 minutes. Three to four injections of 25 ml body temperature isotonic saline were performed into the venous limb of the AV loop. For COTD, five injections of 10 ml ice cold saline were performed. A total of 77 COUD and COTD measurement sets were compared. Cardiac output measured by thermodilution ranged from 3.28 to 9.4 L/min, whereas COUD ranged from 2.85 to 10.1 L/min. The correlation between the methods was found to be r = 0.91, COUD = 0.93(COTD) + 0.42 L/min. Bias and precision (mean difference ± 2SDs) was -0.004 ± 1.34 L/min between the two methods. The percentage error (2SD/mean) was 22.2%, which is below the clinically acceptable limit (<30%). Cardiac output measured by ultrasound dilution and thermodilution methods agreed well in post cardiac surgery ICU patients and hence can be interchangeably used. PMID:21245798

  1. Accuracy of thermodilution measurement of cardiac output in low flows applicable to feline and small canine patients.

    PubMed

    Dyson, D H; McDonnell, W N; Horne, J A

    1984-10-01

    A model system of feline or small canine cardiac output was used to produce known liquid flow rates in the range of 100 to 750 mL/min for comparison against a thermodilution technique of flow measurement. Thermal indicator size was decided by the thermal time concentration curve detected by the Edwards 9520A cardiac output computer. Ten consecutive readings for each flow were made. Regression analysis and Student's t-test were used to evaluate the results. The computer was found to give good correlation with the accurate flow measured by a graduated cylinder over a period of time (r = 0.99). An error of less than 7% overestimation of flow by thermodilution was found with flows greater than 200 mL/min (p less than 0.05). A significant error of more than 20% overestimation of the actual flow occurred with flows less than 200 mL/min (p less than 0.05). The Edwards 9520A computer was compared to the older Edwards 9510A model by averaged triplicate measurements at six different cardiac outputs in an anesthetized cat. The measurements were not significantly different (p less than 0.01). Thermodilution using an Edwards computer proves to be a promising tool in the measurement of low flows applicable to feline and small canine cardiac outputs. PMID:6509371

  2. Improved noninvasive method for measurement of cardiac output and evaluation of left-sided cardiac valve incompetence

    SciTech Connect

    Kelbaek, H.

    1989-05-01

    A time-saving method was developed to label red blood cells in vitro with /sup 99m/Tc while avoiding centrifugation. After tin incubation, extracellular tin was oxidized by sodium hypochlorite, and EDTA was added for stabilizing the complex prior to /sup 99m/Tc incubation. Labeling yields were 95%, and in vivo decay showed a high stability with a mean biologic half-life of eleven hours. The first-passage radionuclide technique for determination of cardiac output using the above-mentioned tracer was evaluated by using the left ventricle as area-of-interest with individual background correction after complete mixing of the tracer. This technique showed a high level of agreement with invasive methods. By combining this method for measurement of the forward stroke volume with the multigated equilibrium principle for determination of the total left ventricular stroke volume using similar background corrections, an exact evaluation of regurgitation fractions was obtained. In patients with aortic and mitral valve disease the noninvasive radionuclide technique gave similar but probably more accurate results as compared with contrast aortography and ventriculography. The radionuclide technique may be suitable for monitoring and selecting patients for surgical treatment.

  3. Thermal dilution measurement of cardiac output in dogs using an analog computer.

    PubMed

    Hendriks, F F; Schipperheyn, J J; Quanjer, P H

    1978-01-01

    Thermal dilution cardiac output determinations in dogs were compared to simultaneously performed Fick oxygen measurements. The purpose of this study was to validate in dog experiments a method for thermal dilution measurement which employs a double-thermistor catheter combined with an automatic computer as described by Olsson et al. Dilution and injectate temperature are entered directly into the calculation. The method does not employ logarithmic extrapolation, integration of the dilution signal being terminated when a preset cut-off level is reached. Errors due to recirculation, thermal capacitance of the right heart and heat exchange with the catheter's dead space require the use of an empirically derived correction factor, which in dogs was found to be significantly different from the factor used for human thermal dilution curves. With the appropriate cut-off level and correction factor a good agreement was found between the results of the thermal dilution and the Fick method. The regression equation for 47 experiments was found to be COtd = 0.95 COFick + 0.08; the correlation coefficient was 0.94. PMID:728031

  4. Measurement of cardiac output during exercise by open-circuit acetylene uptake.

    PubMed

    Barker, R C; Hopkins, S R; Kellogg, N; Olfert, I M; Brutsaert, T D; Gavin, T P; Entin, P L; Rice, A J; Wagner, P D

    1999-10-01

    Noninvasive measurement of cardiac output (QT) is problematic during heavy exercise. We report a new approach that avoids unpleasant rebreathing and resultant changes in alveolar PO(2) or PCO(2) by measuring short-term acetylene (C(2)H(2)) uptake by an open-circuit technique, with application of mass balance for the calculation of QT. The method assumes that alveolar and arterial C(2)H(2) pressures are the same, and we account for C(2)H(2) recirculation by extrapolating end-tidal C(2)H(2) back to breath 1 of the maneuver. We correct for incomplete gas mixing by using He in the inspired mixture. The maneuver involves switching the subject to air containing trace amounts of C(2)H(2) and He; ventilation and pressures of He, C(2)H(2), and CO(2) are measured continuously (the latter by mass spectrometer) for 20-25 breaths. Data from three subjects for whom multiple Fick O(2) measurements of QT were available showed that measurement of QT by the Fick method and by the C(2)H(2) technique was statistically similar from rest to 90% of maximal O(2) consumption (VO(2 max)). Data from 12 active women and 12 elite male athletes at rest and 90% of VO(2 max) fell on a single linear relationship, with O(2) consumption (VO(2)) predicting QT values of 9.13, 15.9, 22.6, and 29.4 l/min at VO(2) of 1, 2, 3, and 4 l/min. Mixed venous PO(2) predicted from C(2)H(2)-determined QT, measured VO(2), and arterial O(2) concentration was approximately 20-25 Torr at 90% of VO(2 max) during air breathing and 10-15 Torr during 13% O(2) breathing. This modification of previous gas uptake methods, to avoid rebreathing, produces reasonable data from rest to heavy exercise in normal subjects. PMID:10517785

  5. Validation study of PulseCO system for continuous cardiac output measurement.

    PubMed

    Berberian, George; Quinn, T Alexander; Vigilance, Deon W; Park, David Y; Cabreriza, Santos E; Curtis, Lauren J; Spotnitz, Henry M

    2005-01-01

    Ultrasonic flow probes have been used to optimize biventricular pacing immediately after cardiopulmonary bypass, improving cardiac output (CO) by 10%; however, flow probes must be removed with chest closure. The PulseCO system (LiDCO Limited, Cambridge, UK) may extend optimization into the postoperative period, but controlled validations have not been reported. Six anesthetized pigs were instrumented for right heart bypass. Flow was varied from 3 to 1 L/min and then back to 3 in 0.5 L/min increments for 60 second intervals. CO was measured by ultrasonic flow probe on the aorta and by PulseCO using a femoral arterial line. PulseCO and flow probe accurately measured CO (PulseCO R2: 0.79-0.95; flow probe R2: 0.96-0.99). At flow of 2 L/min, when the heart was paced 30 bpm over the sinus rate, PulseCO falsely indicated an increase in CO (2.13 vs. 2.30 L/min, p = 0.014). When mean arterial pressure was increased by 20% using a phenylephrine infusion, PulseCO falsely indicated an increase in CO (2.13 vs. 2.47 L/min, p = 0.014). When mean arterial pressure was decreased by 20% using a nitroprusside infusion, PulseCO falsely indicated a decrease in CO (2.13 vs. 1.79 L/min, p = 0.003). PulseCO appears to be useful for assessing acute changes in CO if its limitations are recognized. PMID:15745132

  6. A new method of using gas exchange measurements for the noninvasive determination of cardiac output: clinical experiences in adults following cardiac surgery.

    PubMed

    Osterlund, B; Gedeon, A; Krill, P; Johansson, G; Reiz, S

    1995-08-01

    New mathematical algorithms have been applied to a computer controlled closed breathing circuit system for non-invasive measurement of cardiac output (COniv). This system has been described in an animal study. Forty patients were studied 5 and 18 hours after cardiac surgery using the thermodilution technique as the reference (COtd). The variables entered into the algorithms for COniv were oxygen uptake, carbon dioxide elimination, end-tidal carbon dioxide partial pressure, tidal volume and arterial oxygen saturation. Mixed venous carbon dioxide partial pressure was obtained from an automatically implemented short rebreathing manoeuvre. Pulmonary perfusion was calculated by a modified Fick equation for carbon dioxide and the shunt flow added to obtain COniv. During mechanical ventilation, there was a good agreement between COtd and COniv (r = 0.8). The bias was -0.14 l/min and the precision was 0.77 l/min. The reproducibility of COniv was 0.03 l/min and for COtd -0.03 l/min with a standard deviation of the difference being 0.35 l/min for COniv and 0.31 l/min for COtd. In awake, but sedated extubated patients, the method proved unsatisfactory on account for uneven tidal volumes and difficulties with leakage around the mouth piece. We conclude that this new technique provides reliable and reproducible measures of cardiac output in sedated, ventilated patients. PMID:7484024

  7. Bioreactance Is Not Interchangeable with Thermodilution for Measuring Cardiac Output during Adult Liver Transplantation

    PubMed Central

    Han, Sangbin; Lee, Jong Hwan; Kim, Gaabsoo; Ko, Justin Sangwook; Choi, Soo Joo; Kwon, Ji Hae; Heo, Burn Young; Gwak, Mi Sook

    2015-01-01

    Background Thermodilution technique using a pulmonary artery catheter is widely used for the assessment of cardiac output (CO) in patients undergoing liver transplantation. However, the unclearness of the risk-benefit ratio of this method has led to an interest in less invasive modalities. Thus, we evaluated whether noninvasive bioreactance CO monitoring is interchangeable with thermodilution technique. Methods Nineteen recipients undergoing adult-to-adult living donor liver transplantation were enrolled in this prospective observational study. COs were recorded automatically by the two devices and compared simultaneously at 3-minute intervals. The Bland–Altman plot was used to evaluate the agreement between bioreactance and thermodilution. Clinically acceptable agreement was defined as a percentage error of limits of agreement <30%. The four quadrant plot was used to evaluate concordance between bioreactance and thermodilution. Clinically acceptable concordance was defined as a concordance rate >92%. Results A total of 2640 datasets were collected. The mean CO difference between the two techniques was 0.9 l/min, and the 95% limits of agreement were -3.5 l/min and 5.4 l/min with a percentage error of 53.9%. The percentage errors in the dissection, anhepatic, and reperfusion phase were 50.6%, 56.1%, and 53.5%, respectively. The concordance rate between the two techniques was 54.8%. Conclusion Bioreactance and thermodilution failed to show acceptable interchangeability in terms of both estimating CO and tracking CO changes in patients undergoing liver transplantation. Thus, the use of bioreactance as an alternative CO monitoring to thermodilution, in spite of its noninvasiveness, would be hard to recommend in these surgical patients. PMID:26017364

  8. Pulse Wave Velocity and Cardiac Output vs. Heart Rate in Patients with an Implanted Pacemaker Based on Electric Impedance Method Measurement

    NASA Astrophysics Data System (ADS)

    Soukup, Ladislav; Vondra, Vlastimil; Viščor, Ivo; Jurák, Pavel; Halámek, Josef

    2013-04-01

    The methods and device for estimation of cardiac output and measurement of pulse wave velocity simultaneously is presented here. The beat-to-beat cardiac output as well as pulse wave velocity measurement is based on application of electrical impedance method on the thorax and calf. The results are demonstrated in a study of 24 subjects. The dependence of pulse wave velocity and cardiac output on heart rate during rest in patients with an implanted pacemaker was evaluated. The heart rate was changed by pacemaker programming while neither exercise nor drugs were applied. The most important result is that the pulse wave velocity, cardiac output and blood pressure do not depend significantly on heart rate, while the stroke volume is reciprocal proportionally to the heart rate.

  9. [Cardiac output monitoring by impedance cardiography in cardiac surgery].

    PubMed

    Shimizu, H; Seki, S; Mizuguchi, A; Tsuchida, H; Watanabe, H; Namiki, A

    1990-04-01

    The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients. PMID:2362347

  10. Pulsatile flow simulator for comparison of cardiac output measurements by electromagnetic flow meter and thermodilution.

    PubMed

    Jebson, P J; Karkow, W S

    1986-01-01

    This study examined a pulsatile flow simulator for the purpose of evaluating two measurement devices, an extracorporeal flow probe with an electromagnetic flow meter and several thermodilution catheters. We measured the performance of these devices in a range of low to high flows. Using either saline or blood as a perfusate, we obtained different results with these fluids (p less than 0.001). Each catheter behaved in a linear manner, although variation occurred among the catheters with both saline (minimum slope 1.090, maximum slope 1.190) and blood (minimum slope 1.107, maximum slope 1.154). An increase in rate and stroke volumes of the simulator did not demonstrate an identifiable trend in error. The thermodilution catheters were most accurate at 5.0 L/min irrespective of rate, stroke volume, or perfusate used. In contrast, the electromagnetic flow meter accurately represented flows across the wide range of outputs examined (2.4 to 10.7 L/min). (Slope with saline 1.091, slope with blood 1.080) Throughout the range of flow, the flow meter gave a calibration line 5% higher with blood than with saline. The results indicate that accurate measurement of pulsatile blood flow can be achieved in vitro with an electromagnetic flow meter using saline as a perfusate, provided a correction factor is determined and applied to convert values for saline to accurate values for blood. PMID:2940345

  11. Methods and apparatus for determining cardiac output

    NASA Technical Reports Server (NTRS)

    Cohen, Richard J. (Inventor); Mukkamala, Ramakrishna (Inventor); Sherman, Derin A. (Inventor)

    2010-01-01

    The present invention provides methods and apparatus for determining a dynamical property of the systemic or pulmonary arterial tree using long time scale information, i.e., information obtained from measurements over time scales greater than a single cardiac cycle. In one aspect, the invention provides a method and apparatus for monitoring cardiac output (CO) from a single blood pressure signal measurement obtained at any site in the systemic or pulmonary arterial tree or from any related measurement including, for example, fingertip photoplethysmography.According to the method the time constant of the arterial tree, defined to be the product of the total peripheral resistance (TPR) and the nearly constant arterial compliance, is determined by analyzing the long time scale variations (greater than a single cardiac cycle) in any of these blood pressure signals. Then, according to Ohm's law, a value proportional to CO may be determined from the ratio of the blood pressure signal to the estimated time constant. The proportional CO values derived from this method may be calibrated to absolute CO, if desired, with a single, absolute measure of CO (e.g., thermodilution). The present invention may be applied to invasive radial arterial blood pressure or pulmonary arterial blood pressure signals which are routinely measured in intensive care units and surgical suites or to noninvasively measured peripheral arterial blood pressure signals or related noninvasively measured signals in order to facilitate the clinical monitoring of CO as well as TPR.

  12. Use of cardiac output to improve measurement of input function in quantitative dynamic contrast-enhanced MRI

    PubMed Central

    Zhang, Jeff L.; Rusinek, Henry; Bokacheva, Louisa; Chen, Qun; Storey, Pippa; Lee, Vivian S.

    2009-01-01

    Purpose: To validate a new method for converting MR arterial signal intensity versus time curves to arterial input functions (AIF). Materials and Methods: The method constrains AIF with patient's cardiac output (Q). Monte Carlo simulations of MR renography and tumor perfusion protocols were carried out for comparison with two alternative methods: direct measurement and population-averaged input function. MR renography was performed to assess the method's inter- and intra-day reproducibility for renal parameters. Results: In simulations of tumor perfusion, the precision of the parameters (Ktrans and ve) computed using the proposed method was improved by at least a factor of three compared to direct measurement. Similar improvements were obtained in simulations of MR renography. Volunteer study for testing inter-day reproducibility confirmed the improvement of precision in renal parameters when using the proposed method, compared to conventional methods. In another patient study (two injections within one session), the proposed method significantly increased the correlation coefficient (R) between GFR of the two exams (0.92 vs. 0.83), compared to direct measurement. Conclusion: A new method significantly improves the precision of DCE parameters. The method may be especially useful for analyzing repeated DCE examinations, such as monitoring tumor therapy or ACE-inhibitor renography. PMID:19711414

  13. Modelflow underestimates cardiac output in heat-stressed individuals.

    PubMed

    Shibasaki, Manabu; Wilson, Thad E; Bundgaard-Nielsen, Morten; Seifert, Thomas; Secher, Niels H; Crandall, Craig G

    2011-02-01

    An estimation of cardiac output can be obtained from arterial pressure waveforms using the Modelflow method. However, whether the assumptions associated with Modelflow calculations are accurate during whole body heating is unknown. This project tested the hypothesis that cardiac output obtained via Modelflow accurately tracks thermodilution-derived cardiac outputs during whole body heat stress. Acute changes of cardiac output were accomplished via lower-body negative pressure (LBNP) during normothermic and heat-stressed conditions. In nine healthy normotensive subjects, arterial pressure was measured via brachial artery cannulation and the volume-clamp method of the Finometer. Cardiac output was estimated from both pressure waveforms using the Modeflow method. In normothermic conditions, cardiac outputs estimated via Modelflow (arterial cannulation: 6.1 ± 1.0 l/min; Finometer 6.3 ± 1.3 l/min) were similar with cardiac outputs measured by thermodilution (6.4 ± 0.8 l/min). The subsequent reduction in cardiac output during LBNP was also similar among these methods. Whole body heat stress elevated internal temperature from 36.6 ± 0.3 to 37.8 ± 0.4°C and increased cardiac output from 6.4 ± 0.8 to 10.9 ± 2.0 l/min when evaluated with thermodilution (P < 0.001). However, the increase in cardiac output estimated from the Modelflow method for both arterial cannulation (2.3 ± 1.1 l/min) and Finometer (1.5 ± 1.2 l/min) was attenuated compared with thermodilution (4.5 ± 1.4 l/min, both P < 0.01). Finally, the reduction in cardiac output during LBNP while heat stressed was significantly attenuated for both Modelflow methods (cannulation: -1.8 ± 1.2 l/min, Finometer: -1.5 ± 0.9 l/min) compared with thermodilution (-3.8 ± 1.19 l/min). These results demonstrate that the Modelflow method, regardless of Finometer or direct arterial waveforms, underestimates cardiac output during heat stress and during subsequent reductions in cardiac output via LBNP. PMID:21084673

  14. Sham-feeding decreases cardiac output in normal subjects.

    PubMed

    Andersen, H B; Jensen, E W; Madsbad, S; Nielsen, S L; Burcharth, F; Christensen, N J

    1992-07-01

    The cardiovascular effect of sham-feeding was measured in seven healthy non-obese human subjects by the Fick principle using the carbon dioxide rebreathing method. The subjects were resting in the sitting position and were exposed to the sight and smell but not the taste of a breakfast meal. Cardiac output decreased significantly from a mean value of 4.0 1 min-1 to 3.5 1 min-1 during sham-feeding (Friedman, P = 0.004). The cardiac output returned to basal values in all seven subjects when the sensory stimulus was removed. The decrease in cardiac output was due to a decreased stroke volume, whereas heart rate and blood pressure did not change. The mechanism of the decrease in cardiac output during sham-feeding remains to be established. PMID:1505165

  15. Addressing Assumptions for the Use of Non-invasive Cardiac Output Measurement Techniques During Exercise in COPD.

    PubMed

    Perrault, Hélène; Richard, Ruddy; Kapchinsky, Sophia; Baril, Jacinthe; Bourbeau, Jean; Taivassalo, Tanja

    2016-01-01

    The multifactorial functional limitation of COPD increasingly demonstrates the need for an integrated circulatory assessment. In this study cardiac output (Qc) derived from non-inert (CO2-RB), inert (N2O-RB) gas rebreathing approaches and bioimpedance were compared to examine the limitations of currently available non-invasive techniques for exercise Qc determination in patients with chronic lung disease. Thirteen COPD patients (GOLD II-III) completed three constant cycling bouts at 20, 35, and 50% of peak work on two occasions to assess Qc with bioimpedance as well as using CO2-RB and N2O-RB for all exercise tests. Results showed significantly lower Qc using the N2O-RB or end-tidal CO2-derived Qc compared to the PaCO2-derived CO2-RB or the bioimpedance at rest and for all exercise intensities. End-tidal CO2-derived values are however not statistically different from those obtained using inert-gas rebreathing. This study show that in COPD patients, CO2-rebreathing Qc values obtained using PaCO2 contents which account for any gas exchange impairment or inadequate gas mixing are similar to those obtained using thoracic bioimpedance. Alternately, the lower values for N2O rebreathing derived Qc indicates the inability of this technique to account for gas exchange impairment in the computation of Qc. These findings indicate that the choice of a gas rebreathing technique to measure Qc in patients must be dictated by the ability to include in the derived computations a correction for either gas exchange inadequacies and/or a vascular shunt. PMID:26408087

  16. Newer methods of cardiac output monitoring

    PubMed Central

    Mehta, Yatin; Arora, Dheeraj

    2014-01-01

    Cardiac output (CO) is the volume of blood ejected by each ventricle per minute and is the product of stroke volume and heart rate. CO can thus be manipulated by alteration in heart rate or rhythm, preload, contractility and afterload. Moreover it gives important information about tissue perfusion and oxygen delivery. CO can be measured by various methods and thermodilution method using pulmonary artery catheter (PAC) is till date considered as gold standard method. Complications associated with PAC led to development of newer methods which are minimally or non-invasive. Newer methods fulfil other properties like continuous and reproducible reading, cost effective, reliable during various physiological states and have fast response time. These methods are validated against the gold standard with good level agreement. In this review we have discussed various newer methods of CO monitoring and their effectiveness in clinical use. PMID:25276302

  17. Trending ability and limitations of transpulmonary thermodilution and pulse contour cardiac output measurement in cats as a model for pediatric patients.

    PubMed

    Kutter, Annette P N; Bektas, Rima N; Hofer, Christoph K; Larenza Menzies, M Paula; Bettschart-Wolfensberger, Regula

    2015-06-01

    The present study evaluated transpulmonary thermodilution (TPTD) and pulse contour cardiac output (PCCO) both measured by the PiCCO Plus™ monitor (Pulsion Medical Systems, Munich, Germany) against pulmonary artery thermodilution (PATD) in cats as a hemodynamic model for small children. A wide range of cardiac outputs (CO) was simultaneously measured. Accuracy and trending abilities were critically evaluated. Three cats were studied under isoflurane anesthesia and 160 CO measurements were performed with 3 mL ice-cold 5 % dextrose with PATD and TPTD. The results were compared with the PCCO measurement before the bolus measurement. Cardiac output was manipulated from 32 to 224 mL/kg/min by dobutamine, dopamine, phenylephrine, medetomidine and increased concentrations of isoflurane. Bland-Altman analysis, concordance and polar plot analysis were performed to assess accuracy and trending ability. TPTD was measuring constantly higher than PATD with a mean bias of 73 mL/kg/min and limits of agreement of 34-112 mL/kg/min, a concordance rate of 94 % and a mean polar angle of -5° with radial limits of agreement (RLOA) of 33°. Concordance rate of the PCCO versus PATD was 82 % with a mean polar angle of -10° and RLOA of 46° and versus TPTD 90 % with a mean polar angle of -6° and RLOA of 46°. Both tested methods constantly overestimated simultaneous PATD measurements. The small size, low flows and the relative short catheter not reaching the abdominal aorta may explain that. However TPTD tracked changes accurately opposed to a poor trending ability of the PCCO measurement. PMID:25228023

  18. Evaluation of noninvasive cardiac output methods during exercise

    NASA Technical Reports Server (NTRS)

    Moore, Alan D.; Barrows, Linda H.; Rashid, Michael; Siconolfi, Steven F.

    1992-01-01

    Noninvasive techniques to estimate cardiac output (Qc) will be used during future space flight. This retrospective literature survey compared the Qc techniques of carbon dioxide rebreathing (CO2-R), CO2 single breath (CO2-S), Doppler (DOP), impedance (IM), and inert gas (IG: acetylene or nitrous oxide) to direct (DIR) assessments measured at rest and during exercise.

  19. The ability of stroke volume variation measured by a noninvasive cardiac output monitor to predict fluid responsiveness in mechanically ventilated children.

    PubMed

    Lee, Ji Yeon; Kim, Ji Young; Choi, Chang Hyu; Kim, Hong Soon; Lee, Kyung Cheon; Kwak, Hyun Jeong

    2014-02-01

    Continuous noninvasive cardiac output monitoring (NICOM) is a clinically useful tool in the pediatric setting. This study compared the ability of stroke volume variation (SVV) measured by NICOM with that of respiratory variations in the velocity of aortic blood flow (△Vpeak) and central venous pressure (CVP) to predict of fluid responsiveness in mechanically ventilated children after ventricular septal defect repair. The study investigated 26 mechanically ventilated children after the completion of surgery. At 30 min after their arrival in an intensive care unit, a colloid solution of 10 ml/kg was administrated for volume expansion. Hemodynamic variables, including CVP, stroke volume, and △Vpeak in addition to cardiac output and SVV in NICOM were measured before and 10 min after volume expansion. The patients with a stroke volume increase of more than 15 % after volume expansion were defined as responders. The 26 patients in the study consisted of 13 responders and 13 nonresponders. Before volume expansion, △Vpeak and SVV were higher in the responders (both p values <0.001). The areas under the receiver operating characteristic curves of △Vpeak, SVV, and CVP were respectively 0.956 (95 % CI 0.885-1.00), 0.888 (95 % CI 0.764-1.00), and 0.331 (95 % CI 0.123-0.540). This study showed that SVV by NICOM and △Vpeak by echocardiography, but not CVP, reliably predicted fluid responsiveness during mechanical ventilation after ventricular septal defect repair in children. PMID:23963186

  20. Regulation of cardiac output in hypoxia.

    PubMed

    Siebenmann, Christoph; Lundby, Carsten

    2015-12-01

    This brief review addresses the regulation of cardiac output (Q) at rest and during submaximal exercise in acute and chronic hypoxia. To preserve systemic O2 delivery in acute hypoxia Q is increased by an acceleration of heart rate, whereas stroke volume (SV) remains unchanged. Tachycardia is governed by activation of carotid and aortic chemoreceptors and a concomitant reduction in arterial baroreflex activation, all balancing sympathovagal activity toward sympathetic dominance. As hypoxia extends over several days a combination of different adaptive processes restores arterial O2 content to or beyond sea level values and hence Q normalizes. The latter however occurs as a consequence of a decrease in SV whereas tachycardia persists. The diminished SV reflects a lower left ventricular end-diastolic volume which is primarily related to hypoxia-generated reduction in plasma volume. Hypoxic pulmonary vasoconstriction may contribute by increasing right ventricular afterload and thus decreasing its ejection fraction. In summary, the Q response to hypoxia is the result of a complex interplay between several physiological mechanisms. Future studies are encouraged to establish the individual contributions of the different components from an integrative perspective. PMID:26589118

  1. Noninvasive continuous cardiac output monitoring in perioperative and intensive care medicine.

    PubMed

    Saugel, B; Cecconi, M; Wagner, J Y; Reuter, D A

    2015-04-01

    The determination of blood flow, i.e. cardiac output, is an integral part of haemodynamic monitoring. This is a review on noninvasive continuous cardiac output monitoring in perioperative and intensive care medicine. We present the underlying principles and validation data of the following technologies: thoracic electrical bioimpedance, thoracic bioreactance, vascular unloading technique, pulse wave transit time, and radial artery applanation tonometry. According to clinical studies, these technologies are capable of providing cardiac output readings noninvasively and continuously. They, therefore, might prove to be innovative tools for the assessment of advanced haemodynamic variables at the bedside. However, for most technologies there are conflicting data regarding the measurement performance in comparison with reference methods for cardiac output assessment. In addition, each of the reviewed technology has its own limitations regarding applicability in the clinical setting. In validation studies comparing cardiac output measurements using these noninvasive technologies in comparison with a criterion standard method, it is crucial to correctly apply statistical methods for the assessment of a technology's accuracy, precision, and trending capability. Uniform definitions for 'clinically acceptable agreement' between innovative noninvasive cardiac output monitoring systems and criterion standard methods are currently missing. Further research must aim to further develop the different technologies for noninvasive continuous cardiac output determination with regard to signal recording, signal processing, and clinical applicability. PMID:25596280

  2. Determination of myocardial energetic output for cardiac rhythm pacing.

    PubMed

    Herman, Dalibor; Prevorovská, Svetlana; Marsík, Frantisek

    2007-12-01

    This research is aimed to the determination of the changes in the cardiac energetic output for three different modes of cardiac rhythm pacing. The clinical investigation of thirteen patients with the permanent dual-chamber pacemaker implantation was carried out. The patients were taken to echocardiography examination conducted by way of three pacing modes (AAI, VVI and DDD). The myocardial energetic parameters-the stroke work index (SWI) and the myocardial oxygen consumption (MVO2) are not directly measurable, however, their values can be determined using the numerical model of the human cardiovascular system. The 24-segment hemodynamical model (pulsating type) of the human cardiovascular system was used for the numerical simulation of the changes of myocardial workload for cardiac rhythm pacing. The model was fitted by well-measurable parameters for each patient. The calculated parameters were compared using the two-tailed Student's test. The differences of SWI and MVO2 between the modes AAI and VVI and the modes DDD and VVI are statistically significant (P<0.05). On the other hand, the hemodynamic effects for the stimulation modes DDD and AAI are almost identical, i.e. the differences are statistically insignificant (P>0.05). PMID:18080208

  3. Non-invasive determination of cardiac output by Doppler echocardiography and electrical bioimpedance.

    PubMed Central

    Northridge, D B; Findlay, I N; Wilson, J; Henderson, E; Dargie, H J

    1990-01-01

    Cardiac output measured by thermodilution in 25 patients within 24 hours of acute myocardial infarction was compared with cardiac output measured by Doppler echocardiography (24 patients) and electrical bioimpedance (25 patients). The mean (range) cardiac outputs measured by Doppler (4.03 (2.2-6.0) 1/min) and electrical bioimpedance (3.79 (1.1-6.2) 1/min) were similar to the mean thermodilution value (3.95 (2.1-6.2) 1/min). Both non-invasive techniques agreed closely with thermodilution in most patients. None the less, three results with each method disagreed with thermodilution by more than 1 1/min. Both non-invasive techniques were reproducible and accurate in most patients with acute myocardial infarction. Doppler echocardiography was time consuming and technically demanding. Electrical bioimpedance was simple to use and had the additional advantage of allowing continuous monitoring of the cardiac output. PMID:2317415

  4. Use of the single-breath method of estimating cardiac output during exercise-stress testing.

    NASA Technical Reports Server (NTRS)

    Buderer, M. C.; Rummel, J. A.; Sawin, C. F.; Mauldin, D. G.

    1973-01-01

    The single-breath cardiac output measurement technique of Kim et al. (1966) has been modified for use in obtaining cardiac output measurements during exercise-stress tests on Apollo astronauts. The modifications involve the use of a respiratory mass spectrometer for data acquisition and a digital computer program for data analysis. The variation of the modified method for triplicate steady-state cardiac output measurements was plus or minus 1 liter/min. The combined physiological and methodological variation seen during a set of three exercise tests on a series of subjects was 1 to 2.5 liter/min. Comparison of the modified method with the direct Fick technique showed that although the single-breath values were consistently low, the scatter of data was small and the correlation between the two methods was high. Possible reasons for the low single-breath cardiac output values are discussed.

  5. In vitro evaluation of an ultrasonic cardiac output monitoring (USCOM) device.

    PubMed

    Gregory, Shaun D; Cooney, Helena; Diab, Sara; Anstey, Chris; Thom, Ogilvie; Fraser, John F

    2016-02-01

    Non-invasive cardiac output monitoring techniques provide high yield, low risk mechanisms to identify and individually treat shock in the emergency setting. The non-invasive ultrasonic cardiac output monitoring (USCOM) device uses an ultrasound probe applied externally to the chest; however limitations exist with previous validation strategies. This study presents the in vitro validation of the USCOM device against calibrated flow sensors and compares user variability in simulated healthy and septic conditions. A validated mock circulation loop was used to simulate each condition with a range of cardiac outputs (2-10 l/min) and heart rates (50-95 bpm). Three users with varying degrees of experience using the USCOM device measured cardiac output and heart rate by placing the ultrasound probe on the mock aorta. Users were blinded to the condition, heart rate and cardiac output which were randomly generated. Results were reported as linear regression slope (β). All users estimated heart rate in both conditions with reasonable accuracy (β = 0.86-1.01), while cardiac output in the sepsis condition was estimated with great precision (β = 1.03-1.04). Users generally overestimated the cardiac output in the healthy simulation (β = 1.07-1.26) and reported greater difficulty estimating reduced cardiac output compared with higher values. Although there was some variability between users, particularly in the healthy condition (P < 0.01), all estimations were within a clinically acceptable range. In this study the USCOM provided a suitable measurement of cardiac output and heart rate when compared with our in vitro system. It is a promising technique to assist with the identification and treatment of shock. PMID:25749977

  6. Cardiac Output Assessed by Invasive and Minimally Invasive Techniques

    PubMed Central

    Lee, Allison J.; Cohn, Jennifer Hochman; Ranasinghe, J. Sudharma

    2011-01-01

    Cardiac output (CO) measurement has long been considered essential to the assessment and guidance of therapeutic decisions in critically ill patients and for patients undergoing certain high-risk surgeries. Despite controversies, complications and inherent errors in measurement, pulmonary artery catheter (PAC) continuous and intermittent bolus techniques of CO measurement continue to be the gold standard. Newer techniques provide less invasive alternatives; however, currently available monitors are unable to provide central circulation pressures or true mixed venous saturations. Esophageal Doppler and pulse contour monitors can predict fluid responsiveness and have been shown to decrease postoperative morbidity. Many minimally invasive techniques continue to suffer from decreased accuracy and reliability under periods of hemodynamic instability, and so few have reached the level of interchangeability with the PAC. PMID:21776254

  7. Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients

    PubMed Central

    2010-01-01

    The application of positive end expiratory pressure (PEEP) in mechanically ventilated (MV) patients with acute respiratory distress syndrome (ARDS) decreases cardiac output (CO). Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness. This paper examines combining models of diffusion resistance and lung mechanics, to help predict CO changes due to PEEP. The CO estimator uses an initial measurement of pulmonary shunt, and estimations of shunt changes due to PEEP to predict CO at different levels of PEEP. Inputs to the cardiac model are the PV loops from the ventilator, as well as the oxygen saturation values using known respiratory inspired oxygen content. The outputs are estimates of pulmonary shunt and CO changes due to changes in applied PEEP. Data from two published studies are used to assess and initially validate this model. The model shows the effect on oxygenation due to decreased CO and decreased shunt, resulting from increased PEEP. It concludes that there is a trade off on oxygenation parameters. More clinically importantly, the model also examines how the rate of CO drop with increased PEEP can be used as a method to determine optimal PEEP, which may be used to optimise MV therapy with respect to the gas exchange achieved, as well as accounting for the impact on the cardiovascular system and its management. PMID:21108836

  8. Cardiac output estimation using pulmonary mechanics in mechanically ventilated patients.

    PubMed

    Sundaresan, Ashwath; Chase, J Geoffrey; Hann, Christopher E; Shaw, Geoffrey M

    2010-01-01

    The application of positive end expiratory pressure (PEEP) in mechanically ventilated (MV) patients with acute respiratory distress syndrome (ARDS) decreases cardiac output (CO). Accurate measurement of CO is highly invasive and is not ideal for all MV critically ill patients. However, the link between the PEEP used in MV, and CO provides an opportunity to assess CO via MV therapy and other existing measurements, creating a CO measure without further invasiveness.This paper examines combining models of diffusion resistance and lung mechanics, to help predict CO changes due to PEEP. The CO estimator uses an initial measurement of pulmonary shunt, and estimations of shunt changes due to PEEP to predict CO at different levels of PEEP. Inputs to the cardiac model are the PV loops from the ventilator, as well as the oxygen saturation values using known respiratory inspired oxygen content. The outputs are estimates of pulmonary shunt and CO changes due to changes in applied PEEP. Data from two published studies are used to assess and initially validate this model.The model shows the effect on oxygenation due to decreased CO and decreased shunt, resulting from increased PEEP. It concludes that there is a trade off on oxygenation parameters. More clinically importantly, the model also examines how the rate of CO drop with increased PEEP can be used as a method to determine optimal PEEP, which may be used to optimise MV therapy with respect to the gas exchange achieved, as well as accounting for the impact on the cardiovascular system and its management. PMID:21108836

  9. Continuous cardiac output monitoring by peripheral blood pressure waveform analysis.

    PubMed

    Mukkamala, Ramakrishna; Reisner, Andrew T; Hojman, Horacio M; Mark, Roger G; Cohen, Richard J

    2006-03-01

    A clinical method for monitoring cardiac output (CO) should be continuous, minimally invasive, and accurate. However, none of the conventional CO measurement methods possess all of these characteristics. On the other hand, peripheral arterial blood pressure (ABP) may be measured reliably and continuously with little or no invasiveness. We have developed a novel technique for continuously monitoring changes in CO by mathematical analysis of a peripheral ABP waveform. In contrast to the previous techniques, our technique analyzes the ABP waveform over time scales greater than a cardiac cycle in which the confounding effects of complex wave reflections are attenuated. The technique specifically analyzes 6-min intervals of ABP to estimate the pure exponential pressure decay that would eventually result if pulsatile activity abruptly ceased (i.e., after the high frequency wave reflections vanish). The technique then determines the time constant of this exponential decay, which equals the product of the total peripheral resistance and the nearly constant arterial compliance, and computes proportional CO via Ohm's law. To validate the technique, we performed six acute swine experiments in which peripheral ABP waveforms and aortic flow probe CO were simultaneously measured over a wide physiologic range. We report an overall CO error of 14.6%. PMID:16532772

  10. Volume and its relationship to cardiac output and venous return.

    PubMed

    Magder, S

    2016-01-01

    Volume infusions are one of the commonest clinical interventions in critically ill patients yet the relationship of volume to cardiac output is not well understood. Blood volume has a stressed and unstressed component but only the stressed component determines flow. It is usually about 30 % of total volume. Stressed volume is relatively constant under steady state conditions. It creates an elastic recoil pressure that is an important factor in the generation of blood flow. The heart creates circulatory flow by lowering the right atrial pressure and allowing the recoil pressure in veins and venules to drain blood back to the heart. The heart then puts the volume back into the systemic circulation so that stroke return equals stroke volume. The heart cannot pump out more volume than comes back. Changes in cardiac output without changes in stressed volume occur because of changes in arterial and venous resistances which redistribute blood volume and change pressure gradients throughout the vasculature. Stressed volume also can be increased by decreasing vascular capacitance, which means recruiting unstressed volume into stressed volume. This is the equivalent of an auto-transfusion. It is worth noting that during exercise in normal young males, cardiac output can increase five-fold with only small changes in stressed blood volume. The mechanical characteristics of the cardiac chambers and the circulation thus ultimately determine the relationship between volume and cardiac output and are the subject of this review. PMID:27613307

  11. Evaluation of cardiac output by 5 arterial pulse contour techniques using trend interchangeability method.

    PubMed

    Fischer, Marc-Olivier; Diouf, Momar; Wilde, Robert B P de; Dupont, Hervé; Hanouz, Jean-Luc; Lorne, Emmanuel

    2016-06-01

    Cardiac output measurement with pulse contour analysis is a continuous, mini-invasive, operator-independent, widely used, and cost-effective technique, which could be helpful to assess changes in cardiac output. The 4-quadrant plot and the polar plot have been described to compare the changes between 2 measurements performed under different conditions, and the direction of change by using different methods of measurements. However, the 4-quadrant plot and the polar plot present a number of limitations, with a risk of misinterpretation in routine clinical practice. We describe a new trend interchangeability method designed to objectively define the interchangeability of each change of a variable. Using the repeatability of the reference method, we classified each change as either uninterpretable or interpretable and then as either noninterchangeable, in the gray zone or interchangeable. An interchangeability rate can then be calculated by the number of interchangeable changes divided by the total number of interpretable changes. In this observational study, we used this objective method to assess cardiac output changes with 5 arterial pulse contour techniques (Wesseling's method, LiDCO, PiCCO, Hemac method, and Modelflow) in comparison with bolus thermodilution technique as reference method in 24 cardiac surgery patients. A total of 172 cardiac output variations were available from the 199 data points: 88 (51%) were uninterpretable, according to the first step of the method. The second step of the method, based on the 84 (49%) interpretable variations, showed that only 18 (21%) to 30 (36%) variations were interchangeable regardless of the technique used. None of pulse contour cardiac output technique could be interchangeable with bolus thermodilution to assess changes in cardiac output using the trend interchangeability method in cardiac surgery patients. Future studies may consider using this method to assess interchangeability of changes between different methods

  12. A new closed-system using partially frozen injectate for thermodilution cardiac output determinations.

    PubMed

    Maruta, H; Usuda, Y; Okutsu, Y; Numata, K

    1989-03-01

    The FI (partially frozen injectate) system, a new closed-system devised by the authors for thermodilution cardiac output determinations, has two major features: 1) it needs no ice-filled receptacle to keep injectate cold because it uses partially frozen injectate, and 2) it can go without monitoring the injectate temperatures during the whole process of cardiac output determinations. The author evaluated the accuracy and reproducibility of cardiac output determinations with the FI system in 10 critically ill patients, as compared with another closed-system (which is commercially available) and the standard open method. The injectate temperatures in the FI system were also measured in vitro. The mean injectate temperature in the FI system was 0.71 +/- 0.26 degrees C and 80% of the injectate temperatures were lower than 1.0 degrees C. Even when no monitoring of injectate temperatures was made, the predicated error in the calculated cardiac output resulted as low as 2% with the FI system. The mean cardiac output values were not statistically different between the FI system and the other two systems. PMID:15236053

  13. Oesophageal Doppler monitoring overestimates cardiac output during lumbar epidural anaesthesia.

    PubMed

    Leather, H A; Wouters, P F

    2001-06-01

    Oesophageal Doppler monitoring (ODM) has been advocated as a non-invasive means of measuring cardiac output (CO). However, its reliance upon blood flow measurement in the descending aorta to estimate CO is susceptible to error if blood flow is redistributed between the upper and lower body. We hypothesize that lumbar epidural anesthesia (LEA), which causes blood flow redistribution, causes errors in CO estimates. We compared ODM with thermodilution (TD) measurements in fourteen patients under general anaesthesia for radical prostatectomy, who had received an epidural catheter at the intervertebral level L2-L3. Coupled measurements of CO by means of the TD and ODM techniques were performed at baseline (general anaesthetic only) and after epidural administration of 10 ml of 0.25% bupivacaine. The two methods were compared using Bland-Altman analysis: before LEA there was a bias of -0.89 litre min(-1) with limits of agreement ranging between -2.67 and +0.88 litre min(-1). Following lumbar sympathetic block, bias became positive (+0.55 litre min(-1)) and limits of agreement increased to -3.21 and +4.30 litre min(-1). ODM measured a greater increase in CO after LEA (delta=+1.71 (1.19) litre min(-1) (mean (SD)) compared with TD (delta=+0.51 (0.70) litre min(-1)). We conclude that following LEA, measurements with the Oesophageal Doppler Monitor II overestimate CO and show unacceptably high variability. Blood flow redistribution may limit the value of ODM. PMID:11573585

  14. Redistribution of cardiac output in response to heat exposure in the pony.

    PubMed

    McConaghy, F F; Hodgson, D R; Rose, R J; Hales, J R

    1996-07-01

    Radioactive microspheres were used to measure cardiac output and blood flow to most major tissues in 4 ponies at rest in thermoneutral (16 degrees C/60% RH) and mildly hot (41 degrees C/34% RH) environments. In response to heat stress there were increases in cardiac output (2-fold), respiratory frequency (5-fold), blood flow to the skin of the body (3-fold), and limbs (50%), respiratory muscles (2-fold) and the upper respiratory tract (3-fold). Ponies were able to maintain body temperature in the hot environment by increasing blood flow to the tissues involved in heat dissipation, while blood flow to all other tissues remained stable. This was achieved by increasing the cardiac output without need for reduction of blood flow to other tissues. PMID:8894549

  15. Exercise cardiac output following Skylab missions - The second manned Skylab mission

    NASA Technical Reports Server (NTRS)

    Buderer, M. C.; Mauldin, D. G.; Rummel, J. A.; Michel, E. L.; Sawin, C. F.

    1976-01-01

    Cardiac output was measured during preflight and postflight exercise-stress tests on the Skylab astronauts. In the postflight tests immediately following the 28-, 59-, and 84-d earth orbital missions, the astronauts exhibited an approximate 30% decrease in cardiac output coupled with an approximate 50% decrease in cardiac stroke volume during exercise. These changes were accompanied by elevated heart rates and significant increases in total systemic peripheral vascular resistance. Mean arterial pressure was unchanged. All parameters returned to normal preflight values within 30 d of the end of the orbital period. Duration of the zero-G exposure did not appear to influence either the magnitude of the hemodynamic changes or the time-course of their return to normal. These results are discussed in relation to other cardiovascular findings and possible mechanisms responsible for the observations are outlined.

  16. Thermodynamics of the heart: Relation between cardiac output and oxygen consumption

    NASA Astrophysics Data System (ADS)

    Uehara, Mituo; Sakane, Kumiko K.; Bertolotti, Simone A.

    2008-06-01

    A thermodynamic approach is used to derive a relation between cardiac output and rate of oxygen consumption. As an example, the relation is used to calculate the cardiac output of a young woman exercising on a treadmill. The results can be understood by undergraduates without any previous knowledge of human physiology.

  17. Constant infusion transpulmonary thermodilution for the assessment of cardiac output in exercising humans.

    PubMed

    Calbet, J A L; Mortensen, S P; Munch, G D W; Curtelin, D; Boushel, R

    2016-05-01

    To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of temperature in the femoral artery were used for CITT-Q assessment. CITT-Q was linearly related to ICG-Q (r = 0.82, CITT-Q = 0.876 × ICG-Q + 3.638, P < 0.001; limits of agreement ranging from -1.43 to 3.07 L/min) and BTD-Q (r = 0.91, CITT-Q = 0.822 × BTD + 4.481 L/min, P < 0.001; limits of agreement ranging from -1.01 to 2.63 L/min). Compared with ICG-Q and BTD-Q, CITT-Q overestimated cardiac output by 1.6 L/min (≈ 10% of the mean ICG and BTD-Q values, P < 0.05). For Q between 20 and 28 L/min, we estimated an overestimation < 5%. The coefficient of variation of 23 repeated CITT-Q measurements was 6.0% (CI: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans. PMID:25919489

  18. Validation and application of single breath cardiac output determinations in man

    NASA Technical Reports Server (NTRS)

    Loeppky, J. A.; Fletcher, E. R.; Myhre, L. G.; Luft, U. C.

    1986-01-01

    The results of a procedure for estimating cardiac output by a single-breath technique (Qsb), obtained in healthy males during supine rest and during exercise on a bicycle ergometer, were compared with the results on cardiac output obtained by the direct Fick method (QF). The single breath maneuver consisted of a slow exhalation to near residual volume following an inspiration somewhat deeper than normal. The Qsb calculations incorporated an equation of the CO2 dissociation curve and a 'moving spline' sequential curve-fitting technique to calculate the instantaneous R from points on the original expirogram. The resulting linear regression equation indicated a 24-percent underestimation of QF by the Qsb technique. After applying a correction, the Qsb-QF relationship was improved. A subsequent study during upright rest and exercise to 80 percent of VO2(max) in 6 subjects indicated a close linear relationship between Qsb and VO2 for all 95 values obtained, with slope and intercept close to those in published studies in which invasive cardiac output measurements were used.

  19. Cardiac output variations in supine resting subjects during head-out cold water immersion

    NASA Astrophysics Data System (ADS)

    Vogelaere, P.; Deklunder, G.; Lecroart, J.

    1995-03-01

    Five men, aged 31.2 years (SD 2.3), under semi-nude conditions and resting in a dorsal reclining position, were exposed to thermoneutral air for 30 min, followed immediately by a cold water (15°C) immersion for 60 min. Cardiac output was measured using a dualbeam Doppler flow meter. During immersion in cold water, cardiac frequency ( f c) showed an initial bradycardia. The lowest values were reached at about 10 min after immersion, 58.3 (SD 2.5) to 48.3 (SD 7.8) beats min-1 ( P < 0.05). By the 20th min of exposure, f c had gradually risen to 70.0 beats min-1 (SD 6.6, P < 0.05). This change could be due to the inhibition of the initial vagal reflex by increased catecholamine concentration. Stroke volume ( V s) was significantly increased ( P < 0.05) during the whole cold immersion period. Cardiac output, increased from 3.57 (SD 0.50) to 6.26 (SD 1.33)1 min-1 ( P < 0.05) and its change with time was a function of both V s and f c. On the other hand, systolic flow acceleration was unchanged during the period of immersion. The changes in the respiratory variables (ventilation, oxygen uptake, carbon dioxide output and respiratory exchange ratio) during immersion showed an initial hyperventilation followed, as immersion proceeded, by a slower metabolic increase due to shivering.

  20. Cardiac output variations in supine resting subjects during head-out cold water immersion.

    PubMed

    Vogelaere, P; Deklunder, G; Lecroart, J

    1995-08-01

    Five men, aged 31.2 years (SD 2.3), under semi-nude conditions and resting in a dorsal reclining position, were exposed to thermoneutral air for 30 min, followed immediately by a cold water (15 degrees C) immersion for 60 min. Cardiac output was measured using a dual-beam Doppler flow meter. During immersion in cold water, cardiac frequency (fc) showed an initial bradycardia. The lowest values were reached at about 10 min after immersion, 58.3 (SD 2.5) to 48.3 (SD 7.8) beats min-1 (P < 0.05). By the 20th min of exposure, fc had gradually risen to 70.0 beats min-1 (SD 6.6, P < 0.05). This change could be due to the inhibition of the initial vagal reflex by increased catecholamine concentration. Stroke volume (Vs) was significantly increased (P < 0.05) during the whole cold immersion period. Cardiac output, increased from 3.57 (SD 0.50) to 6.26 (SD 1.33) l min-1 (P < 0.05) and its change with time was a function of both Vs and fc. On the other hand, systolic flow acceleration was unchanged during the period of immersion. The changes in the respiratory variables (ventilation, oxygen uptake, carbon dioxide output and respiratory exchange ratio) during immersion showed an initial hyperventilation followed, as immersion proceeded, by a slower metabolic increase due to shivering. PMID:7558407

  1. Cardiac Output and Performance during a Marathon Race in Middle-Aged Recreational Runners

    PubMed Central

    Billat, Véronique L.; Petot, Hélène; Landrain, Morgan; Meilland, Renaud; Koralsztein, Jean Pierre; Mille-Hamard, Laurence

    2012-01-01

    Purpose. Despite the increasing popularity of marathon running, there are no data on the responses of stroke volume (SV) and cardiac output (CO) to exercise in this context. We sought to establish whether marathon performance is associated with the ability to sustain high fractional use of maximal SV and CO (i.e, cardiac endurance) and/or CO, per meter (i.e., cardiac cost). Methods. We measured the SV, heart rate (HR), CO, and running speed of 14 recreational runners in an incremental, maximal laboratory test and then during a real marathon race (mean performance: 3 hr 30 min ± 45 min). Results. Our data revealed that HR, SV and CO were all in a high but submaximal steady state during the marathon (87.0 ± 1.6%, 77.2 ± 2.6%, and 68.7 ± 2.8% of maximal values, respectively). Marathon performance was inversely correlated with an upward drift in the CO/speed ratio (mL of CO × m−1) (r = −0.65, P < 0.01) and positively correlated with the runner's ability to complete the race at a high percentage of the speed at maximal SV (r = 0.83, P < 0.0002). Conclusion. Our results showed that marathon performance is inversely correlated with cardiac cost and positively correlated with cardiac endurance. The CO response could be a benchmark for race performance in recreational marathon runners. PMID:22645458

  2. Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring

    PubMed Central

    Napoli, Anthony M.

    2012-01-01

    Clinical assessment and vital signs are poor predictors of the overall hemodynamic state. Optimal measurement of the response to fluid resuscitation and hemodynamics has previously required invasive measurement with radial and pulmonary artery catheterization. Newer noninvasive resuscitation technology offers the hope of more accurately and safely monitoring a broader range of critically ill patients while using fewer resources. Fluid responsiveness, the cardiac response to volume loading, represents a dynamic method of improving upon the assessment of preload when compared to static measures like central venous pressure. Multiple new hemodynamic monitors now exist that can noninvasively report cardiac output and oxygen delivery in a continuous manner. Proper assessment of the potential future role of these techniques in resuscitation requires understanding the underlying physiologic and clinical principles, reviewing the most recent literature examining their clinical validity, and evaluating their respective advantages and limitations. PMID:21860802

  3. High Power Amplifier Harmonic Output Level Measurement

    NASA Technical Reports Server (NTRS)

    Perez, R. M.; Hoppe, D. J.; Khan, A. R.

    1995-01-01

    A method is presented for the measurement of the harmonic output power of high power klystron amplifiers, involving coherent hemispherical radiation pattern measurements of the radiated klystron output. Results are discussed for the operation in saturated and unsaturated conditions, and with a waveguide harmonic filter included.

  4. Continuous noninvasive cardiac output determination using the CNAP system: evaluation of a cardiac output algorithm for the analysis of volume clamp method-derived pulse contour.

    PubMed

    Wagner, Julia Y; Grond, Julian; Fortin, Jürgen; Negulescu, Ileana; Schöfthaler, Miriam; Saugel, Bernd

    2016-08-01

    The CNAP system (CNSystems Medizintechnik AG, Graz, Austria) provides noninvasive continuous arterial pressure measurements by using the volume clamp method. Recently, an algorithm for the determination of cardiac output by pulse contour analysis of the arterial waveform recorded with the CNAP system became available. We evaluated the agreement of the continuous noninvasive cardiac output (CNCO) measurements by CNAP in comparison with cardiac output measurements invasively obtained using transpulmonary thermodilution (TDCO). In this proof-of-concept analysis we studied 38 intensive care unit patients from a previously set up database containing CNAP-derived arterial pressure data and TDCO values obtained with the PiCCO system (Pulsion Medical Systems SE, Feldkirchen, Germany). We applied the new CNCO algorithm retrospectively to the arterial pressure waveforms recorded with CNAP and compared CNCO with the corresponding TDCO values (criterion standard). Analyses were performed separately for (1) CNCO calibrated to the first TDCO (CNCO-cal) and (2) CNCO autocalibrated to biometric patient data (CNCO-auto). We did not perform an analysis of trending capabilities because the patients were hemodynamically stable. The median age and APACHE II score of the 22 male and 16 female patients was 63 years and 18 points, respectively. 18 % were mechanically ventilated and in 29 % vasopressors were administered. Mean ± standard deviation for CNCO-cal, CNCO-auto, and TDCO was 8.1 ± 2.7, 6.4 ± 1.9, and 7.8 ± 2.4 L/min, respectively. For CNCO-cal versus TDCO, Bland-Altman analysis demonstrated a mean difference of +0.2 L/min (standard deviation 1.0 L/min; 95 % limits of agreement -1.7 to +2.2 L/min, percentage error 25 %). For CNCO-auto versus TDCO, the mean difference was -1.4 L/min (standard deviation 1.8 L/min; 95 % limits of agreement -4.9 to +2.1 L/min, percentage error 45 %). This pilot analysis shows that CNCO determination is feasible in critically

  5. The Prognostic Value of Peak Cardiac Power Output in Chinese Patients with Chronic Heart Failure

    PubMed Central

    Ma, Wenlin; Gong, Zhu; Ni, Yi; Zhang, Xiaoyu; Xu, Wenjun; Jiang, Jinfa; Che, Lin; Xu, Jiahong; Yan, Wenwen; Zhou, Lin; Li, Guanghe; Zhang, Qiping; Wang, Lemin

    2016-01-01

    Background Cardiopulmonary exercise testing has been widely used to risk stratify patients with chronic heart failure (CHF). Peak oxygen consumption (peakVO2) was regarded as a powerful predictor of survival, as it is a surrogate for peak cardiac output (CO), which by most is considered the “true” measure of heart failure. Therefore, it is reasonable to hypothesize that CO is an even stronger predictor than peak VO2. The present study is aimed to investigate the prognostic value of peak cardiac power output (peak CPO) in comparison with peakVO2 in Chinese patients with CHF. Methods Participants provided written informed consent to participate in this study. Totally 129 patients with CHF underwent symptom-limited cardiopulmonary exercise testing (CPET), with mean age 59.1±11.4 years, 87.6% male, 57.4% ischemic etiology, body mass index (BMI) 24.7±3.7 kg/m2 and LVEF 38±9%. CO was measured using an inert gas rebreathing method. The primary endpoints are cardiac deaths. Results Over median 33.7-month follow-up, 19 cardiac deaths were reported. Among peak VO2,VE/VCO2 slope and Peak CPO, their area under ROC were 0.64, 0.67, 0.68, respectively (Ρ<0.05).The optimal thresholds for predicting cardiac deaths were peak VO2≤13.4 ml.kg-1.min-1, and VE/VCO2 slope≥39.3 and peak CPO≤ 1.1 respectively by ROC analysis. Finally, in patients with a peak VO2≤13.4 ml.kg-1.min-1 those with peak CPO>1.1W had better survival than those with peak CPO ≤ 1.1W. However, by multivariate analysis adjusted for age, sex, BMI, resting heart rate, LVMI, LVEF, Peak CPO was not an independent predictor of cardiac deaths (P> 0.05). Conclusions Peak CPO was not a predictor of cardiac death in Chinese CHF patients. PMID:26808510

  6. Office Skills: Measuring Typewriting Output.

    ERIC Educational Resources Information Center

    Petersen, Lois E.; Kruk, Leonard B.

    1978-01-01

    The advent of word processing centers has provided typewriting teachers with an alternative measurement system that, instead of penalizing errors, grades students according to Usable Lines Produced (ULP). The ULP system is job-oriented and promotes realistic office standards in typewriting productivity. (MF)

  7. Shoshin Beriberi With Low Cardiac Output and Hemodynamic Deterioration Treated Dramatically by Thiamine Administration.

    PubMed

    Imamura, Teruhiko; Kinugawa, Koichiro

    2015-01-01

    "Shoshin beriberi", which is a fulminant form of cardiovascular beriberi accompanied by hemodynamic deterioration with high cardiac output and decreased systemic blood pressure, caused by thiamine deficiency due to alcoholic abuse or malnutrition, is often difficult to address because of its rarity and non-specific symptoms. We here present a patient with a history of alcoholic abuse who had suffered hemodynamic deterioration with extremely low cardiac output refractory to extracorporeal membrane oxygenation and intravenous catecholamine support, which was improved dramatically by bolus intravenous thiamine administration. Such a type with low cardiac output would be the most severe form of Shoshin beriberi, and cannot be rescued without diagnostic administration of thiamine. PMID:26346515

  8. Minimally invasive cardiac output monitoring: agreement of oesophageal Doppler, LiDCOrapid™ and Vigileo FloTrac™ monitors in non-cardiac surgery.

    PubMed

    Phan, T D; Kluger, R; Wan, C

    2016-05-01

    There is lack of data about the agreement of minimally invasive cardiac output monitors, which make it impossible to determine if they are interchangeable or differ objectively in tracking physiological trends. We studied three commonly used devices: the oesophageal Doppler and two arterial pressure-based devices, the Vigileo FloTrac™ and LiDCOrapid™. The aim of this study was to compare the agreement of these three monitors in adult patients undergoing elective non-cardiac surgery. Measurements were taken at baseline and after predefined clinical interventions of fluid, metaraminol or ephedrine bolus. From 24 patients, 131 events, averaging 5.2 events per patient, were analysed. The cardiac index of LiDCOrapid versus FloTrac had a mean bias of -6.0% (limits of agreement from -51% to 39%) and concordance of over 80% to the three clinical interventions. The cardiac index of Doppler versus LiDCOrapid and Doppler versus FloTrac, had an increasing negative bias at higher mean cardiac outputs and there was significantly poorer concordance to all interventions. Of the preload-responsive parameters, Doppler stroke volume index, Doppler systolic flow time and FloTrac stroke volume variation were fair at predicting fluid responsiveness while other parameters were poor. While there is reasonable agreement between the two arterial pressure-derived cardiac output devices (LiDCOrapid and Vigileo FloTrac), these two devices differ significantly to the oesophageal Doppler technology in response to common clinical intraoperative interventions, representing a limitation to how interchangeable these technologies are in measuring cardiac output. PMID:27246939

  9. Initial Observations of the Effects of Calcium Chloride Infusions in Pediatric Patients with Low Cardiac Output.

    PubMed

    Averin, Konstantin; Villa, Chet; Krawczeski, Catherine D; Pratt, Jesse; King, Eileen; Jefferies, John L; Nelson, David P; Cooper, David S; Ryan, Thomas D; Sawyer, Jaclyn; Towbin, Jeffrey A; Lorts, Angela

    2016-03-01

    Myocardial contractility and relaxation are highly dependent on calcium homeostasis. Immature myocardium, as in pediatric patients, is thought to be more dependent on extracellular calcium for optimal function. For this reason, intravenous calcium chloride infusions may improve myocardial function in the pediatric patient. The objectives of this study were to report the hemodynamic changes seen after administration of continuous calcium chloride to critically ill children. We retrospectively identified pediatric patients (newborn to 17 years old) with hemodynamic instability admitted to the cardiac ICU between May 2011 and May 2012 who received a continuous infusion of calcium chloride. The primary outcome was improvement in cardiac output, assessed by arterial-mixed venous oxygen saturation (A-V) difference. Sixty-eight patients, mean age 0.87 ± 2.67 years, received a total of 116 calcium infusions. Calcium chloride infusions resulted in significant improvements in primary and secondary measures of cardiac output at 2 and 6 h. Six hours after calcium initiation, A-V oxygen saturation difference decreased by 7.4 % (32.6 ± 2.1 to 25.2 ± 2.0 %, p < 0.001), rSO2 increased by 5.5 % (63.1 vs 68.6 %, p < 0.001), and serum lactate decreased by 0.9 mmol/l (3.3 vs 2.4 mmol/l, p < 0.001) with no change in HR (149.1 vs 145.6 bpm p = 0.07). Urine output increased 0.66 ml/kg/h in the 8-h period after calcium initiation when compared to pre-initiation (p = 0.003). Neonates had the strongest evidence of effectiveness with other age groups trending toward significance. Calcium chloride infusions improve markers of cardiac output in a heterogenous group of pediatric patients in a cardiac ICU. Neonates appear to derive the most benefit from utilization of these infusions. PMID:26687150

  10. Measuring cardiac waste: the premier cardiac waste measures.

    PubMed

    Lowe, Timothy J; Partovian, Chohreh; Kroch, Eugene; Martin, John; Bankowitz, Richard

    2014-01-01

    The authors developed 8 measures of waste associated with cardiac procedures to assist hospitals in comparing their performance with peer facilities. Measure selection was based on review of the research literature, clinical guidelines, and consultation with key stakeholders. Development and validation used the data from 261 hospitals in a split-sample design. Measures were risk adjusted using Premier's CareScience methodologies or mean peer value based on Medicare Severity Diagnosis-Related Group assignment. High variability was found in resource utilization across facilities. Validation of the measures using item-to-total correlations (range = 0.27-0.78), Cronbach α (.88), and Spearman rank correlation (0.92) showed high reliability and discriminatory power. Because of the level of variability observed among hospitals, this study suggests that there is opportunity for facilities to design successful waste reduction programs targeting cardiac-device procedures. PMID:23719033

  11. High flow variant postural orthostatic tachycardia syndrome amplifies the cardiac output response to exercise in adolescents

    PubMed Central

    Pianosi, Paolo T.; Goodloe, Adele H.; Soma, David; Parker, Ken O.; Brands, Chad K.; Fischer, Philip R.

    2014-01-01

    Abstract Postural orthostatic tachycardia syndrome (POTS) is characterized by chronic fatigue and dizziness and affected individuals by definition have orthostatic intolerance and tachycardia. There is considerable overlap of symptoms in patients with POTS and chronic fatigue syndrome (CFS), prompting speculation that POTS is akin to a deconditioned state. We previously showed that adolescents with postural orthostatic tachycardia syndrome (POTS) have excessive heart rate (HR) during, and slower HR recovery after, exercise – hallmarks of deconditioning. We also noted exaggerated cardiac output during exercise which led us to hypothesize that tachycardia could be a manifestation of a high output state rather than a consequence of deconditioning. We audited records of adolescents presenting with long‐standing history of any mix of fatigue, dizziness, nausea, who underwent both head‐up tilt table test and maximal exercise testing with measurement of cardiac output at rest plus 2–3 levels of exercise, and determined the cardiac output () versus oxygen uptake () relationship. Subjects with chronic fatigue were diagnosed with POTS if their HR rose ≥40 beat·min−1 with head‐up tilt. Among 107 POTS patients the distribution of slopes for the , relationship was skewed toward higher slopes but showed two peaks with a split at ~7.0 L·min−1 per L·min−1, designated as normal (5.08 ± 1.17, N = 66) and hyperkinetic (8.99 ± 1.31, N = 41) subgroups. In contrast, cardiac output rose appropriately with in 141 patients with chronic fatigue but without POTS, exhibiting a normal distribution and an average slope of 6.10 ± 2.09 L·min−1 per L·min−1. Mean arterial blood pressure and pulse pressure from rest to exercise rose similarly in both groups. We conclude that 40% of POTS adolescents demonstrate a hyperkinetic circulation during exercise. We attribute this to failure of normal regional vasoconstriction during exercise, such that patients must increase

  12. Stormy Course of a Huge Submitral Aneurysm Causing Low Cardiac Output State

    PubMed Central

    Gokhroo, Rajendra Kumar; Kishor, Kamal; Ranwa, Bhanwar

    2016-01-01

    Submitral aneurysm is a rare structural abnormality of congenital or acquired aetiology. Most reported cases are from Africa. Unless promptly treated surgically this condition is invariably fatal. We report a case of a young Indian male who presented with dyspnea of recent onset, diagnosed to have a massive submitral aneurysm causing low cardiac output and compression of cardiac structures. PMID:27081448

  13. Cardiac output and vasodilation in the vasovagal response: An analysis of the classic papers.

    PubMed

    Wieling, Wouter; Jardine, David L; de Lange, Frederik J; Brignole, Michele; Nielsen, Henning B; Stewart, Julian; Sutton, Richard

    2016-03-01

    The simple faint is secondary to hypotension and bradycardia resulting in transient loss of consciousness. According to Ohm's law applied to the circulation, BP = SVR × CO, hypotension can result from a decrease in systemic vascular resistance (SVR), cardiac output (CO), or both. It is important to understand that when blood pressure (BP) is falling, SVR and CO do not change reciprocally as they do in the steady state. In 1932, Lewis, assuming that decreased SVR alone accounted for hypotension, defined "the vasovagal response" along pathophysiologic lines to denote the association of vasodilation with vagal-induced bradycardia in simple faint. Studies performed by Barcroft and Sharpey-Schafer between 1940 and 1950 used volume-based plethysmography to demonstrate major forearm vasodilation during extreme hypotension and concluded that the main mechanism for hypotension was vasodilation. Plethysmographic measurements were intermittent and not frequent enough to capture rapid changes in blood flow during progressive hypotension. However, later investigations by Weissler, Murray, and Stevens performed between 1950 and 1970 used invasive beat-to-beat BP measurements and more frequent measurements of CO using the Fick principle. They demonstrated that CO significantly fell before syncope, and little vasodilation occurred until very late in the vasovagal reaction Thus, since the 1970s, decreasing cardiac output rather than vasodilation has been regarded as the principal mechanism for the hypotension of vasovagal syncope. PMID:26598322

  14. Quantification of the Impaired Cardiac Output Response to Exercise in Heart Failure: Application of a Non-Invasive Device

    PubMed Central

    Myers, Jonathan; Gujja, Pradeep; Neelagaru, Suresh; Hsu, Leon; Burkhoff, Daniel

    2009-01-01

    An impaired cardiac output (CO) response to exercise is a hallmark of chronic heart failure (CHF), and the degree to which CO is impaired is related to the severity of CHF and prognosis. However, practical methods for obtaining cardiac output during exercise are lacking, and what constitutes and impaired response is unclear. Forty six CHF patients and 13 normal subjects underwent cardiopulmonary exercise testing (CPX) while CO and other hemodynamic measurements at rest and during exercise were obtained using a novel, non-invasive, bioreactance device based on assessment of relative phase shifts of electric currents injected across the thorax, heart rate and ventricular ejection time. An abnormal cardiac output response to exercise was defined as achieving ≤ 95% of the confidence limits of the slope of the relationship between CO and oxygen uptake (VO2). An impaired CO slope identified patients with more severe CHF as evidenced by a lower peak VO2, lower peak CO, heightened VE/VCO2 slope, and lower oxygen uptake efficiency slope. CO can be estimated during exercise using a novel bioreactance technique; patients with an impaired response to exercise exhibit reduced exercise capacity and inefficient ventilation typical of more severe CHF. Non- invasive measurement of cardiac performance in response to exercise provides a simple method of identifying patients with more severe CHF and may complement the CPX in identifying CHF patients at high risk. Key points Non-invasive measurement of cardiac output during exercise is feasible in patients with heart failure. Impairment in the CO response to exercise identifies heart failure patients with more severe disease, lower exercise capacity and inefficient ventilation. Non-invasive measurement of cardiac performance during exercise has potentially important applications for the functional and prognostic assessment of patients with heart failure. PMID:24149996

  15. Negative pressure breathing increases cardiac output and nitrogen elimination in seated subjects.

    PubMed

    Lundgren, Claes E G; Eckhardt, Lukas G; Senf, Curtis J; Bowdwin, Melina R; Pendergast, David R

    2013-01-01

    During denitrogenation for rescue, crew members of an internally pressurized disabled submarine (DISSUB) must sit upright, which may hamper venous return, cardiac output and peripheral circulation. Since negative pressure breathing (NPB) might counteract this problem, denitrogenation was measured in sitting subjects performing NPB. Seven male subjects completed 125-minute nitrogen (N2) washouts breathing either 100% oxygen (O2) or a normoxic gas (21% O2 in argon) in control conditions and intermittent (I: inspirations only) or continuous (C) NPB at -10 or -15 cmH2O. N2 elimination was measured using a closed rebreathing system. INPB (intermittent) (-15cmH2O) and CNPB (continous breathing) (-10 and -15cmH2O) increased cardiac output (CO) 9% during both O2 and normoxic breathing. Systolic and diastolic blood pressures were unaffected by the CO increase, suggesting a peripheral vasodilatation and enhanced tissue perfusion leading to increased N2 elimination. With the CO boost, N2 washout increased 6% breathing O2 at -15 cmH2O CNPB and INPB, while during normoxic breathing there were 6% and 12% increases due to CNBP, -10 and -15 respectively and 6% with -15cmH2O INPB; breathing 100% O2 yielding 5% to 15% less N2 washout than normoxic breathing. Negative pressure breathing during denitrogenation may facilitate decompression in divers and in crew members being rescued from a DISSUB. PMID:24224284

  16. Cardiac output during cardiopulmonary resuscitation at various compression rates and durations.

    PubMed

    Fitzgerald, K R; Babbs, C F; Frissora, H A; Davis, R W; Silver, D I

    1981-09-01

    Cardiac output during cardiopulmonary resuscitation (CPR) was measured by a modified indicator-dilution technique in 20 anesthetized dogs (6-12 kg), during repeated 1- to 2-min episodes of electrically induced ventricular fibrillation, by a mechanical chest compressor and ventilator. With compression rates from 20 to 140/min and compression durations (duty cycles) from 10 to 90% of cycle time, cardiac output (CO) was predicted by the equation: CO = CR . SVmax . [DC/(k1 . CR + DC)] . [(1 -- DC)/k2 . CR + 1 - DC)], where CR is compression rate, DC is duty cycle, SVmax (19 ml) is the effective capacity of the pumping chamber, and k1 (0.00207 min) and k2 (0.00707 min) are ejection and filling constants. This expression predicts maximal CO for DC = 0.40 and cR = 126/min and 90-100% of maximal CO for 0.3 less than DC less than 0.5 and 70 less than CR less than 150/min. Such mathematical analysis may prove useful in the optimization of CPR. PMID:7282953

  17. Reference values for total blood volume and cardiac output in humans

    SciTech Connect

    Williams, L.R.

    1994-09-01

    Much research has been devoted to measurement of total blood volume (TBV) and cardiac output (CO) in humans but not enough effort has been devoted to collection and reduction of results for the purpose of deriving typical or {open_quotes}reference{close_quotes} values. Identification of normal values for TBV and CO is needed not only for clinical evaluations but also for the development of biokinetic models for ultra-short-lived radionuclides used in nuclear medicine (Leggett and Williams 1989). The purpose of this report is to offer reference values for TBV and CO, along with estimates of the associated uncertainties that arise from intra- and inter-subject variation, errors in measurement techniques, and other sources. Reference values are derived for basal supine CO and TBV in reference adult humans, and differences associated with age, sex, body size, body position, exercise, and other circumstances are discussed.

  18. Hypotension during cemented arthroplasty. Relationship to cardiac output and fat embolism.

    PubMed

    Wheelwright, E F; Byrick, R J; Wigglesworth, D F; Kay, J C; Wong, P Y; Mullen, J B; Waddell, J P

    1993-09-01

    An episode of hypotension is common during cemented joint replacement, and has been associated with circulatory collapse and sudden death. We studied the mechanism of hypotension in two groups of six dogs after simulated bilateral cemented arthroplasty. In one group, with no lavage, the insertion of cement and prosthesis was followed by severe hypotension, elevated pulmonary artery pressure, decreased systemic vascular resistance and a 21% reduction in cardiac output. In the other group, pulsatile intramedullary lavage was performed before the simulated arthroplasties. Hypotension was less, and although systemic vascular resistance decreased, the cardiac output did not change. The severity of the hypotension, the decrease in cardiac output and an increase in prostaglandin metabolites were related to the magnitude of pulmonary fat embolism. Pulsatile lavage prevents much of this fat embolism, and hence the decrease in cardiac output. The relatively mild hypotension after lavage was secondary to transient vasodilation, which may accentuate the hypotension caused by the decreased cardiac output due to a large embolic fat load. We make recommendations for the prevention and management of hypotension during cemented arthroplasty. PMID:8376426

  19. Cardiac output, at rest and during exercise, before and during myocardial ischemia, reperfusion, and infarction in conscious mice.

    PubMed

    Lujan, Heidi L; DiCarlo, Stephen E

    2013-02-15

    Multiple systems and regulatory strategies interact to control cardiac homeostasis. In fact, regulated systems, feedback controls, and redundant control mechanisms dominate in whole animals. Accordingly, molecular and cellular tools and techniques must be utilized in complex models with multiple systems and regulatory strategies to fully appreciate the physiological context. Currently, these techniques are mainly performed under conditions remote from the normal in vivo condition; thus, the extrapolation of molecular changes to the in vivo situation and the facilitation of translational aspect of the findings are limited. A major obstacle has been the reliance on preparations that do not mimic the clinical or physiological situation. This is particularly true regarding measurements of cardiac function in mice. To address these concerns, we used a permanently implanted Doppler ultrasonic flow probe on the ascending aorta and coronary artery occluder for repeated measurements of ascending aortic blood flow (cardiac output) in conscious mice, at rest and during exercise, before and during coronary artery occlusion/reperfusion and infarction. The conscious mouse model permits detailed monitoring of within-animal changes in cardiac function during myocardial ischemia, reperfusion, and infarction in an intact, complex model free of the confounding influences of anesthetics, surgical trauma, and restraint stress. Results from this study suggest that previous protocols may have overestimated resting baseline values and underestimated cardiac output reserve. Using these procedures in currently available spontaneous or engineered mouse mutants has the potential to be of major importance for advancing the concepts and methods that drive cardiovascular research. PMID:23302959

  20. The feasibility and applications of non-invasive cardiac output monitoring, thromboelastography and transit-time flow measurement in living-related renal transplantation surgery: results of a prospective pilot observational study

    PubMed Central

    2014-01-01

    Introduction Delayed graft function (DGF) remains a significant and detrimental postoperative phenomenon following living-related renal allograft transplantation, with a published incidence of up to 15%. Early therapeutic vasodilatory interventions have been shown to improve DGF, and modifications to immunosuppressive regimens may subsequently lessen its impact. This pilot study assesses the potential applicability of perioperative non-invasive cardiac output monitoring (NICOM), transit-time flow monitoring (TTFM) of the transplant renal artery and pre-/perioperative thromboelastography (TEG) in the early prediction of DGF and perioperative complications. Methods Ten consecutive living-related renal allograft recipients were studied. Non-invasive cardiac output monitoring commenced immediately following induction of anaesthesia and was maintained throughout the perioperative period. Doppler-based TTFM was performed during natural haemostatic pauses in the transplant surgery: immediately following graft reperfusion and following ureteric implantation. Central venous blood sampling for TEG was performed following induction of anaesthesia and during abdominal closure. Results A single incidence of DGF was seen within the studied cohort and one intra-operative (thrombotic) complication noted. NICOM confirmed a predictable trend of increased cardiac index (CI) following allograft reperfusion (mean CI - clamped: 3.17 ± 0.29 L/min/m2, post-reperfusion: 3.50 ± 0.35 L/min/m2; P < 0.05) mediated by a significant reduction in total peripheral resistance. Reduced TTFM at the point of allograft reperfusion (227 ml/min c.f. mean; 411 ml/min (95% CI: 358 to 465)) was identified in a subject who experienced intra-operative transplant renal artery thrombosis. TEG data exhibited significant reductions in clot lysis (LY30 (%): pre-op: 1.0 (0.29 to 1.71), post reperfusion 0.33 (0.15 to 0.80); P = 0.02) and a trend towards increased clot initiation following

  1. Rowing increases stroke volume and cardiac output to a greater extent than cycling.

    PubMed

    Horn, P; Ostadal, P; Ostadal, B

    2015-01-01

    Exercise stimulates increases in heart rate (HR), stroke volume (SV) and cardiac output (CO). These adaptive mechanisms are strongly dependent on the type of exercise. Both rowing and cycling are widely used for physical training worldwide; however, evidence regarding the differences in major hemodynamic parameters during rowing and cycling remains insufficient. Ten healthy male volunteers were randomly assigned to perform either a rowing or cycling exercise. After 20 min rest, the group who had rowed first performed the cycling exercise and vice versa. Exercise was performed at a power-to-weight ratio of 2 W/kg for 2 min. HR, SV, CO and blood pressure (BP) were measured noninvasively using pulse-wave analysis at baseline and immediately after each exercise. HR, SV and CO were significantly higher after exercise than at rest. Whereas HR was comparable between rowing and cycling, SV and CO were significantly higher after rowing than after cycling. BP was comparable among all three measurements. Rowing increased SV and CO to a greater extent than cycling, whereas HR and BP were not influenced by the type of exercise. Our data suggest that rowing leads to more extensive stimulation of cardiac contractility and/or decreases in peripheral vascular resistance compared with cycling. PMID:25317691

  2. Cardiac output is an apparent determinant of nitroglycerin pharmacokinetics in rats.

    PubMed

    Fung, H L; Blei, A; Chong, S

    1986-12-01

    The steady-state pharmacokinetics of nitroglycerin (NTG) were investigated in 11 rats after sequential infusions of either NTG alone (10 micrograms/kg/min) or NTG plus vasopressin (the latter at 5.5 mU/kg/min). Arterial and venous plasma concentrations of NTG in the femoral bed were obtained at 41 and 45 min during each infusion phase. Cardiac output was estimated twice in each animal using 85Sr and 141Ce microspheres. NTG systemic clearance in arterial plasma was found to be strongly correlated with cardiac output (r = 0.784, n = 22, P less than .001). Because NTG distribution between red blood cells and plasma was independent of concentration (up to 150 ng/ml in plasma) and hematocrit (25-48%), the systemic clearance of NTG in arterial blood could be estimated as about 3/4 of cardiac output. Vasopressin co-infusion decreased both the cardiac output and the arterial NTG plasma clearance, but it also increased the arteriovenous extraction of NTG. Thus, vasopressin had not net effect on the venous plasma clearance, of NTG. In animals with NTG infusions alone, cardiac output also significantly correlated with NTG venous plasma clearance (P less than .01) and arteriovenous extraction (P less than .05). These data indicate that, in the absence of vasopressin, NTG pharmacokinetics are dependent on the cardiac output, thus providing an example wherein the systemic clearance of a drug was shown to be related to systemic blood flow. These results support the concept that the vasculature acts as a clearing organ for organic nitrates, and they also provide a hemodynamic explanation for the high variability in NTG plasma concentrations observed under presumed steady-state conditions. PMID:3098960

  3. Sildenafil improves cardiac output and exercise performance during acute hypoxia, but not normoxia.

    PubMed

    Hsu, Andrew R; Barnholt, Kimberly E; Grundmann, Nicolas K; Lin, Joseph H; McCallum, Stewart W; Friedlander, Anne L

    2006-06-01

    Sildenafil causes pulmonary vasodilation, thus potentially reducing impairments of hypoxia-induced pulmonary hypertension on exercise performance at altitude. The purpose of this study was to determine the effects of sildenafil during normoxic and hypoxic exercise. We hypothesized that 1) sildenafil would have no significant effects on normoxic exercise, and 2) sildenafil would improve cardiac output, arterial oxygen saturation (SaO2), and performance during hypoxic exercise. Ten trained men performed one practice and three experimental trials at sea level (SL) and simulated high altitude (HA) of 3,874 m. Each cycling test consisted of a set-work-rate portion (55% work capacity: 1 h SL, 30 min HA) followed immediately by a time trial (10 km SL, 6 km HA). Double-blinded capsules (placebo, 50, or 100 mg) were taken 1 h before exercise in a randomly counterbalanced order. For HA, subjects also began breathing hypoxic gas (12.8% oxygen) 1 h before exercise. At SL, sildenafil had no effects on any cardiovascular or performance measures. At HA, sildenafil increased stroke volume (measured by impedance cardiography), cardiac output, and SaO2 during set-work-rate exercise. Sildenafil lowered 6-km time-trial time by 15% (P<0.05). SaO2 was also higher during the time trial (P<0.05) in response to sildenafil, despite higher work rates. Post hoc analyses revealed two subject groups, sildenafil responders and nonresponders, who improved time-trial performance by 39% (P<0.05) and 1.0%, respectively. No dose-response effects were observed. During cycling exercise in acute hypoxia, sildenafil can greatly improve cardiovascular function, SaO2, and performance for certain individuals. PMID:16455814

  4. In vivo validation of cardiac output assessment in non-standard 3D echocardiographic images

    NASA Astrophysics Data System (ADS)

    Nillesen, M. M.; Lopata, R. G. P.; de Boode, W. P.; Gerrits, I. H.; Huisman, H. J.; Thijssen, J. M.; Kapusta, L.; de Korte, C. L.

    2009-04-01

    Automatic segmentation of the endocardial surface in three-dimensional (3D) echocardiographic images is an important tool to assess left ventricular (LV) geometry and cardiac output (CO). The presence of speckle noise as well as the nonisotropic characteristics of the myocardium impose strong demands on the segmentation algorithm. In the analysis of normal heart geometries of standardized (apical) views, it is advantageous to incorporate a priori knowledge about the shape and appearance of the heart. In contrast, when analyzing abnormal heart geometries, for example in children with congenital malformations, this a priori knowledge about the shape and anatomy of the LV might induce erroneous segmentation results. This study describes a fully automated segmentation method for the analysis of non-standard echocardiographic images, without making strong assumptions on the shape and appearance of the heart. The method was validated in vivo in a piglet model. Real-time 3D echocardiographic image sequences of five piglets were acquired in radiofrequency (rf) format. These ECG-gated full volume images were acquired intra-operatively in a non-standard view. Cardiac blood flow was measured simultaneously by an ultrasound transit time flow probe positioned around the common pulmonary artery. Three-dimensional adaptive filtering using the characteristics of speckle was performed on the demodulated rf data to reduce the influence of speckle noise and to optimize the distinction between blood and myocardium. A gradient-based 3D deformable simplex mesh was then used to segment the endocardial surface. A gradient and a speed force were included as external forces of the model. To balance data fitting and mesh regularity, one fixed set of weighting parameters of internal, gradient and speed forces was used for all data sets. End-diastolic and end-systolic volumes were computed from the segmented endocardial surface. The cardiac output derived from this automatic segmentation was

  5. A multiple-input multiple-output system for modeling the cardiac dynamics.

    PubMed

    Monzon, Jorge E; Picaza, Carlos Alvarez; Pisarello, Maria I

    2011-01-01

    We describe the dynamics of the cardiovascular system by finding the input-output relationships in the state space of a functional cardiac model, based on state equations and observability criteria of control theory. The unit step response of the multiple-input multiple-output system model illustrates the damping effect of the arterial wall to the pulsatility of the heart. Our results show that hypertensive patients exhibit a lower inertia of the blood flow. PMID:22254491

  6. Age and sex influence the balance between maximal cardiac output and peripheral vascular reserve.

    PubMed

    Ridout, Samuel J; Parker, Beth A; Smithmyer, Sandra L; Gonzales, Joaquin U; Beck, Kenneth C; Proctor, David N

    2010-03-01

    We evaluated the influence of age and sex on the relationship between central and peripheral vasodilatory capacity. Healthy men (19 younger, 12 older) and women (17 younger, 17 older) performed treadmill and knee extensor exercise to fatigue on separate days while maximal cardiac output (Q, acetylene uptake) and peak femoral blood flow (FBF, Doppler ultrasound) were measured, respectively. Maximal Q was reduced with age similarly in men (Y: 23.6 +/- 2.7 vs. O: 17.4 +/- 3.5 l/min; P < 0.05) and women (Y: 17.7 +/- 1.9 vs. O: 12.3 +/- 1.6 l/min; P < 0.05). Peak FBF was similar between younger (Y) and older (O) men (Y: 2.1 +/- 0.5 vs. O: 2.2 +/- 0.7 l/min) but was lower in older women compared with younger women (Y: 1.9 +/- 0.4 vs. O: 1.4 +/- 0.4 l/min; P < 0.05). Maximal Q was positively correlated with peak FBF in men (Y: r = 0.55, O: r = 0.74; P < 0.05) but not in women (Y: r = 0.34, O: r = 0.10). Normalization of cardiac output to appendicular muscle mass and peak FBF to quadriceps mass reduced the correlation between these variables in younger men (r = 0.30), but the significant association remained in older men (r = 0.68; P < 0.05), with no change in women. These data suggest that 1) aerobic capacity is associated with peripheral vascular reserve in men but not women, and 2) aging is accompanied by a more pronounced sex difference in this relationship. PMID:19959767

  7. Effect of Hemorrhage on Cardiac Output, PVP, Alodosterone and Diuresis during Immersion in Men

    NASA Technical Reports Server (NTRS)

    Simanonok, K.; Greenleaf, John E.; Bernauer, E. M.; Wade, C. E.; Keil, L. C.

    1990-01-01

    The purpose of this study was to test the hypothesis that a reduction in blood volume would attenuate or eliminate immersion-induced increases in cardiac output (Q (sup dot) sub co)) and urine excretion, and to investigate accompanying vasoactive and fluid-electrolyte hormonal responses.

  8. Pulmonary diffusing capacity, capillary blood volume, and cardiac output during sustained microgravity

    NASA Technical Reports Server (NTRS)

    Prisk, G. K.; Guy, Harold J. B.; Elliott, Ann R.; Deutschman, Robert A., III; West, John B.

    1993-01-01

    We measured pulmonary diffusing capacity (DL), diffusing capacity per unit lung volume, pulmonary capillary blood volume (Vc), membrane diffusing capacity (Dm), pulmonary capillary blood flow or cardiac output (Qc), and cardiac stroke volume (SV) in four subjects exposed to nine days of microgravity. DL in microgravity was elevated compared with preflight standing values and was higher than preflight supine because of the elevation of both Vc and Dm. The elevation in Vc was comparable to that measured supine in 1 G, but the increase in Dm was in sharp contrast to the supine value. We postulate that, in 0 G, pulmonary capillary blood is evenly distributed throughout the lung, providing for uniform capillary filling, leading to an increase in the surface area available for diffusion. By contrast, in the supine 1-G state, the capillaries are less evenly filled, and although a similar increase in blood volume is observed, the corresponding increase in surface area does not occur. DL and its subdivisions showed no adaptive changes from the first measurement 24 h after the start of 0 G to eight days later. Similarly, there were no trends in the postflight data, suggesting that the principal mechanism of these changes was gravitational. The increase in Dm suggests that subclinical pulmonary edema did not result from exposure to 0 G. Qc was modestly increased inflight and decreased postflight compared with preflight standing. Compared with preflight standing, SV was increased 46 percent inflight and decreased 14 percent in the 1st week postflight. There were temporal changes in Qc and SV during 0 G, with the highest values recorded at the first measurement, 24 h into the flight. The lowest values of Qc and SV occurred on the day of return.

  9. Assessment of the effect of vasodilators on the distribution of cardiac output by whole-body Thallium imaging

    SciTech Connect

    Juni, J.E.; Wallis, J.; Diltz, E.; Nicholas, J.; Lahti, D.; Pitt, B.

    1985-05-01

    Vasodilator therapy (tx) of congestive heart failure (CHF) has been shown to be effective in increasing cardiac output (CO) and lowering vascular resistance. Unfortunately, these hemodynamic effects are not usually accompanied by improved peripheral circulation of exercise capacity. To assess the effect of a new vasodilator, Cl-914, on the redistribution of CO to the peripheral circulation, the authors performed testing whole-body thallium scanning (WB-Th) on 6 patients (pts) with severe CHF. Immediately following i.v. injection of 1.5 mCi Th-201, WB scanning was performed from anterior and posterior views. Regions of interest were defined for the peripheral (P) muscles (legs and arms), central torso (C), and splanchnic bed (S). The geometric mean of activity in these regions was calculated from both views. Each pt was studied before tx and again, after 1 week on tx. Invasive measurements revealed that all pts had significant improvements in resting cardiac output (mean increase 49%) and vascular resistance (mean decrease 30%). Unlike other vasodilators, all CI-914 pts had a significant improvement in treadmill exercise capacity (mean increase 54%). WB-Th revealed a significant shift in CO to the peripheral circulation with P:C increased 33.2% (rho= .001) and P:S increased 29% (rho=.01). Vasoactive drugs may significantly alter the relative distribution of cardiac output. WB-Th scanning provides a simple quantitative means of following such changes.

  10. 47 CFR 2.1046 - Measurements required: RF power output.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurements required: RF power output. 2.1046... Measurements required: RF power output. (a) For transmitters other than single sideband, independent sideband and controlled carrier radiotelephone, power output shall be measured at the RF output terminals...

  11. Age and cardiac output during cycle exercise in thermoneutral and warm environments.

    PubMed

    Minson, C T; Kenney, W L

    1997-01-01

    To determine whether chronological age, independent of changes in aerobic capacity, alters cardiac output (Qc), the central hemodynamic responses to intermittent incremental cycle exercise were studied in two groups of men. Qc was measured at rest and during exercise at 35%, 60%, 75%, and 85% peak aerobic capacity (VO2peak) using a CO2 rebreathing method in seven trained older (65 +/- 2 yr) and eight normally active but untrained young men (26 +/- 1 yr) matched for VO2peak and anthropometric measures. Subjects were tested in both a thermoneutral (22 degrees C) and a warm (36 degrees C) environment to investigate possible differential cardiovascular responses to exercise in the heat. Only subjects with no history of pulmonary, cardiac, neuromuscular, or endocrine disease and a normal electrocardiogram were studied. The older men had significantly lower (P < 0.05) Qc relative to the younger men at intensities greater than 60% VO2peak in both environmental conditions. At these higher intensities, the older men had a significantly higher stroke volume (SV) and lower heart rate (HR) (P < 0.05). A higher arteriovenous oxygen difference ((a-v)O2)) compared with their younger counterparts enabled the older men to exercise at the same absolute intensity, most likely because of training induced changes in left-ventricular performance and oxygen extraction. The addition of an exogenous heat source did not alter the Qc response in either group of men; however, a higher HR (P < 0.05) and smaller SV (P > 0.05) were observed in the young men during exercise in the heat. This may reflect previously reported differences in the skin blood flow response of VO2peak-matched young and older men during exercise. It is suggested that endurance trained older men can enhance left-ventricular performance to augment SV, but not sufficiently to maintain Qc in light of an attenuated HR response during exercise at intensities above 60% VO2peak. PMID:9000158

  12. Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure–Prone Rats

    PubMed Central

    Farraj, Aimen K.

    2013-01-01

    Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel engine exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance of normal cardiac function. To explore this putative mechanism, we examined cardiophysiologic responses to DE inhalation in a model of aged heart failure–prone rats without signs or symptoms of overt heart failure. We hypothesized that acute DE exposure would alter heart rhythm, cardiac electrophysiology, and ventricular performance and dimensions consistent with autonomic imbalance while increasing biochemical markers of toxicity. Spontaneously hypertensive heart failure rats (16 months) were exposed once to whole DE (4h, target PM2.5 concentration: 500 µg/m3) or filtered air. DE increased multiple heart rate variability (HRV) parameters during exposure. In the 4h after exposure, DE increased cardiac output, left ventricular volume (end diastolic and systolic), stroke volume, HRV, and atrioventricular block arrhythmias while increasing electrocardiographic measures of ventricular repolarization (i.e., ST and T amplitudes, ST area, T-peak to T-end duration). DE did not affect heart rate relative to air. Changes in HRV positively correlated with postexposure changes in bradyarrhythmia frequency, repolarization, and echocardiographic parameters. At 24h postexposure, DE-exposed rats had increased serum C-reactive protein and pulmonary eosinophils. This study demonstrates that cardiac effects of DE inhalation are likely to occur through changes in autonomic balance associated with modulation of cardiac electrophysiology and mechanical function and may offer insights into the adverse health effects of traffic-related air pollutants. PMID:23047911

  13. Comparison of electrical velocimetry and cardiac magnetic resonance imaging for the non-invasive determination of cardiac output.

    PubMed

    Trinkmann, Frederik; Berger, Manuel; Doesch, Christina; Papavassiliu, Theano; Schoenberg, Stefan O; Borggrefe, Martin; Kaden, Jens J; Saur, Joachim

    2016-08-01

    A novel algorithm of impedance cardiography referred to as electrical velocimetry (EV) has been introduced for non-invasive determination of cardiac output (CO). Previous validation studies yielded diverging results and no comparison with the non-invasive gold standard cardiac magnetic resonance imaging (CMR) has been performed. We therefore aimed to prospectively assess the accuracy and reproducibility of EV compared to CMR. 152 consecutive stable patients undergoing CMR were enrolled. EV measurements were taken twice before or after CMR in supine position and averaged over 20 s (AESCULON(®), Osypka Medical, Berlin, Germany). Bland-Altman analysis showed insufficient agreement of EV and CMR with a mean bias of 1.2 ± 1.4 l/min (bias 23 ± 26 %, percentage error 51 %). Reproducibility was high with 0.0 ± 0.3 l/min (bias 0 ± 8 %, percentage error 15 %). Outlier analysis revealed gender, height, CO and stroke volume (SV) by CMR as independent predictors for larger variation. Stratification of COCMR in quintiles demonstrated a good agreement for low values (<4.4 l/min) with bias increasing significantly with quintile as high as 3.1 ± 1.1 l/min (p < 0.001). Reproducibility was not affected (p = 0.71). Subgroup analysis in patients with arrhythmias (p = 0.19), changes in thoracic fluid content (p = 0.51) or left heart failure (p = 0.47) could not detect significant differences in accuracy. EV showed insufficient agreement with CMR and good reproducibility. Gender, height and increasing CO and SV were associated with increased bias while not affecting reproducibility. Therefore, absolute values should not be used interchangeably in clinical routine. EV yet may find its place for clinical application with further investigation on its trending ability pending. PMID:26115774

  14. Clinical review: Guyton - the role of mean circulatory filling pressure and right atrial pressure in controlling cardiac output

    PubMed Central

    2010-01-01

    Arthur Guyton's concepts of the determinative role of right heart filling in cardiac output continue to be controversial. This paper reviews his seminal experiments in detail and clarifies the often confusing concepts underpinning his model. One primary criticism of Guyton's model is that the parameters describing venous return had not been measured in a functioning cardiovascular system in humans. Thus, concerns have been expressed in regard to the ability of Guyton's simplistic model, with few parameters, to model the complex human circulation. Further concerns have been raised in regard to the artificial experimental preparations that Guyton used. Recently reported measurements in humans support Guyton's theoretical and animal work. PMID:21144008

  15. Peripartum cardiomyopathy: postpartum decompensation and use of non-invasive cardiac output monitoring.

    PubMed

    Lorello, G; Cubillos, J; McDonald, M; Balki, M

    2014-02-01

    The utility of a non-invasive cardiac output monitor (NICOM™) in guiding the peripartum management and identification of postpartum complications in a patient with severe peripartum cardiomyopathy is reported. A 31-year-old nulliparous woman at 35 weeks of gestation presented with a three-week history of worsening dyspnea and progressive functional deterioration. A transthoracic echocardiogram showed severe left ventricular systolic dysfunction with an ejection fraction <20%. Cardiac status was monitored using NICOM™ during labor and delivery. The baseline values were: cardiac output 5.3 L/min, total peripheral resistance 1549 dynes.sec/cm(5), stroke volume 42.1 mL and stroke volume variation 18%. She received early epidural analgesia during labor, titrated slowly with a loading dose of 0.0625% bupivacaine 10 mL and fentanyl 25 μg, followed by patient-controlled epidural analgesia (0.0625% bupivacaine with fentanyl 2 μg/mL, infusion at 10 mL/h, bolus dose 5 mL and lockout interval 10 min). After epidural drug administration, total peripheral resistance decreased, cardiac output increased, and satisfactory analgesia was obtained. She had an uneventful vaginal delivery with a forceps-assisted second stage after prophylactic administration of furosemide 20 mg. NICOM™ was discontinued after delivery. Fifteen hours post-delivery, the patient developed cardiogenic shock, which resolved after aggressive therapy with inotropes and furosemide. NICOM™ can be used to guide treatment during labor and delivery in patients with critical peripartum cardiomyopathy. We suggest that use of NICOM™ be extended into the postpartum period to detect signs of cardiac decompensation in such patients. PMID:24360329

  16. Assumed oxygen consumption based on calculation from dye dilution cardiac output: an improved formula.

    PubMed

    Bergstra, A; van Dijk, R B; Hillege, H L; Lie, K I; Mook, G A

    1995-05-01

    This study was performed because of observed differences between dye dilution cardiac output and the Fick cardiac output, calculated from estimated oxygen consumption according to LaFarge and Miettinen, and to find a better formula for assumed oxygen consumption. In 250 patients who underwent left and right heart catheterization, the oxygen consumption VO2 (ml.min-1) was calculated using Fick's principle. Either pulmonary or systemic flow, as measured by dye dilution, was used in combination with the concordant arteriovenous oxygen concentration difference. In 130 patients, who matched the age of the LaFarge and Miettinen population, the obtained values of oxygen consumption VO2(dd) were compared with the estimated oxygen consumption values VO2(lfm), found using the LaFarge and Miettinen formulae. The VO2(lfm) was significantly lower than VO2(dd); -21.8 +/- 29.3 ml.min-1 (mean +/- SD), P < 0.001, 95% confidence interval (95% CI) -26.9 to -16.7, limits of agreement (LA) -80.4 to 36.9. A new regression formula for the assumed oxygen consumption VO2(ass) was derived in 250 patients by stepwise multiple regression analysis. The VO2(dd) was used as a dependent variable, and body surface area BSA (m2). Sex (0 for female, 1 for male), Age (years), Heart rate (min-1) and the presence of a left to right shunt as independent variables. The best fitting formula is expressed as: VO2(ass) = (157.3 x BSA + 10.0 x Sex - 10.5 x In Age + 4.8) ml.min-1, where ln Age = the natural logarithm of the age. This formula was validated prospectively in 60 patients. A non-significant difference between VO2(ass) and VO2(dd) was found; mean 2.0 +/- 23.4 ml.min-1, P = 0.771, 95% Cl = -4.0 to +8.0, LA -44.7 to +48.7. In conclusion, assumed oxygen consumption values, using our new formula, are in better agreement with the actual values than those found according to LaFarge and Miettinen's formulae. PMID:7588904

  17. A novel continuous cardiac output monitor based on pulse wave transit time.

    PubMed

    Sugo, Yoshihiro; Ukawa, Teiji; Takeda, Sunao; Ishihara, Hironori; Kazama, Tomiei; Takeda, Junzo

    2010-01-01

    Monitoring cardiac output (CO) is important for the management of patient circulation in an operation room (OR) or intensive care unit (ICU). We assumed that the change in pulse wave transit time (PWTT) obtained from an electrocardiogram (ECG) and a pulse oximeter wave is correlated with the change in stroke volume (SV), from which CO is derived. The present study reports the verification of this hypothesis using a hemodynamic analysis theory and animal study. PWTT consists of a pre-ejection period (PEP), the pulse transit time through an elasticity artery (T(1)), and the pulse transit time through peripheral resistance arteries (T(2)). We assumed a consistent negative correlation between PWTT and SV under all conditions of varying circulatory dynamics. The equation for calculating SV from PWTT was derived based on the following procedures. 1. Approximating SV using a linear equation of PWTT. 2. The slope and y-intercept of the above equation were determined under consideration of vessel compliance (SV was divided by Pulse Pressure (PP)), animal type, and the inherent relationship between PP and PWTT. Animal study was performed to verify the above-mentioned assumption. The correlation coefficient of PWTT and SV became r = -0.710 (p 〈 0.001), and a good correlation was admitted. It has been confirmed that accurate continuous CO and SV measurement is only possible by monitoring regular clinical parameters (ECG, SpO2, and NIBP). PMID:21095971

  18. Laboratory measurement of human power output during maximum intensity exercise

    NASA Astrophysics Data System (ADS)

    Lakomy, Henryk K. A.

    1993-11-01

    The power output of an athlete decreases rapidly with time. The author describes different ways of measuring power output, including a unique method developed at Loughborough University for measuring the power developed by a sprint runner.

  19. Improved system measures output energy of pyrotechnic devices

    NASA Technical Reports Server (NTRS)

    Shortly, E. M.

    1966-01-01

    System for measuring the output energy of pyrotechnic devices discharges the reaction products into a test chamber. It measures the radiant heat output from a pinhole aperture as well as internal pressure changes on a common time base.

  20. Noninvasive measurement of cardiac performance in recovery from exercise in heart failure patients

    PubMed Central

    Myers, Jonathan N; Gujja, Pradeep; Neelagaru, Suresh; Hsu, Leon; Burkhoff, Daniel

    2011-01-01

    OBJECTIVE: To examine the association between cardiac performance during recovery and the severity of heart failure, as determined by clinical and cardiopulmonary exercise test responses. METHODS: As part of a retrospective cohort study, 46 heart failure patients and 13 normal subjects underwent cardiopulmonary exercise testing while cardiac output was measured using a noninvasive device. Cardiac output in recovery was expressed as the slope of a single exponential relationship between cardiac output and time; the recovery-time constant was assessed in relation to indices of cardiac function, along with clinical, functional, and cardiopulmonary exercise responses. RESULTS: The recovery time constant was delayed in patients with heart failure compared with normal subjects (296.7±238 vs. 110.1±27 seconds, p <0.01), and the slope of the decline of cardiac output in recovery was steeper in normal subjects compared with heart failure patients (p<0.001). The slope of the decline in cardiac output recovery was inversely related to peak VO2 (r = -0.72, p<0.001) and directly related to the VE/VCO2 slope (r = 0.57, p<0.001). Heart failure patients with abnormal recovery time constants had lower peak VO2, lower VO2 at the ventilatory threshold, lower peak cardiac output, and a heightened VE/VCO2 slope during exercise. CONCLUSIONS: Impaired cardiac output recovery kinetics can identify heart failure patients with more severe disease, lower exercise capacity, and inefficient ventilation. Estimating cardiac output in recovery from exercise may provide added insight into the cardiovascular status of patients with heart failure. PMID:21655761

  1. The effects of long-term aerobic exercise on cardiac structure, stroke volume of the left ventricle, and cardiac output

    PubMed Central

    Lee, Bo-Ae; Oh, Deuk-Ja

    2016-01-01

    The purpose of this study is to investigate the effect of the long-term aerobic exercises on cardiac structure, left ventricular stroke volume, and cardiac output. To achieve the purpose of the study, a total of 22 volunteers—including 10 people who have continued regular exercises and 12 people as the control group—were selected as subjects. With regard to data processing, the IBM SPSS Statistics ver. 21.0 was used to calculate the mean and standard deviation, and the difference of the means between the groups was verified through an independent t-test. As a result, there were significant differences between groups in the left ventricular end-diastolic internal dimension, left ventricular end-systolic internal dimension, left ventricular end-diastolic septum thickness. There were significant differences between groups in left ventricular end-diastolic volume, left ventricular mass, and left ventricular mass index per body surface area. However, in cardiac function, only left ventricular stroke volume showed a significant difference between groups. PMID:26933658

  2. The effects of long-term aerobic exercise on cardiac structure, stroke volume of the left ventricle, and cardiac output.

    PubMed

    Lee, Bo-Ae; Oh, Deuk-Ja

    2016-02-01

    The purpose of this study is to investigate the effect of the long-term aerobic exercises on cardiac structure, left ventricular stroke volume, and cardiac output. To achieve the purpose of the study, a total of 22 volunteers-including 10 people who have continued regular exercises and 12 people as the control group-were selected as subjects. With regard to data processing, the IBM SPSS Statistics ver. 21.0 was used to calculate the mean and standard deviation, and the difference of the means between the groups was verified through an independent t-test. As a result, there were significant differences between groups in the left ventricular end-diastolic internal dimension, left ventricular end-systolic internal dimension, left ventricular end-diastolic septum thickness. There were significant differences between groups in left ventricular end-diastolic volume, left ventricular mass, and left ventricular mass index per body surface area. However, in cardiac function, only left ventricular stroke volume showed a significant difference between groups. PMID:26933658

  3. Relationship between impaired chronotropic response, cardiac output during exercise, and exercise tolerance in patients with chronic heart failure.

    PubMed

    Samejima, Hisanori; Omiya, Kazuto; Uno, Masato; Inoue, Kohji; Tamura, Masachika; Itoh, Kae; Suzuki, Kengo; Akashi, Yoshihiro; Seki, Atsushi; Suzuki, Noriyuki; Osada, Naohiko; Tanabe, Kazuhiko; Miyake, Fumihiko; Itoh, Haruki

    2003-07-01

    The present study was undertaken to investigate the relationship between the extent of impaired chronotropic response and cardiac output during exercise, and exercise tolerance in patients with chronic heart failure. The subjects consisted of 24 patients (mean 60.1 +/- 14.0 years) who had mild chronotropic incompetence. Cardiopulmonary exercise testing was performed in all patients, and heart rate (HR), anaerobic threshold (AT), maximum oxygen uptake (peak VO2), slope of the regression line relating the ventilatory equivalent to carbon dioxide output (VE/VCO2 slope), and exercise time were measured. Cardiac output (CO) was measured by a thoracic bioimpedance method and cardiac index (CI) was calculated. Plasma norepinephrine (NE) was measured at rest and immediately after the exercise test. The changes in HR, NE, and CI from the resting state to immediately after exercise were calculated as deltaHR, deltaNE, and deltaCI, respectively. The deltaNE was converted to a logarithmic scale and deltaHR/log deltaNE was used as a parameter of HR response to sympathetic nerve stimulation. The results were as follows: HR and NE in the resting state had no correlation with AT and with peak VO2. DeltaHR/log deltaNE correlated positively with both AT and peak VO2, and negatively with the VE/CO2 slope. DeltaHR/log deltaNE correlated positively with peak CI, %deltaCI, and deltaCI/exercise time. The data suggest that one of the mechanisms of low exercise tolerance in chronic heart failure patients was due to an inadequate increase in CO response against exercise caused by an impaired HR response to increased NE. PMID:12906033

  4. Urine Output During Cardiopulmonary Bypass Predicts Acute Kidney Injury After Cardiac Surgery

    PubMed Central

    Song, Young; Kim, Dong Wook; Kwak, Young Lan; Kim, Beom Seok; Joo, Hyung Min; Ju, Jin Woo; Yoo, Young Chul

    2016-01-01

    Abstract Urine output is closely associated with renal function and has been used as a diagnostic criterion for acute kidney injury (AKI). However, urine output during cardiopulmonary bypass (CPB) has never been identified as a predictor of postoperative AKI. Considering altered renal homeostasis during CPB, we made a comprehensible approach to CPB urine output and evaluated its predictability for AKI. Patients undergoing cardiovascular surgery with the use of CPB, between January 2009 and December 2011, were retrospectively reviewed. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL in the first postoperative 48 hours. We extrapolated a possible optimal amount of urine output from the plot of probability of AKI development according to CPB urine output. After separating patients by the predicted optimal value, we performed stepwise logistic regression analyses to find potential predictors of AKI in both subgroups. A total of 696 patients were analyzed. The amount of CPB urine output had a biphasic association with the incidence of AKI using 4 mL/kg/h as a boundary value. In a multivariate logistic regression to find predictors for AKI in entire patients, CPB urine output did not show statistical significance. After separating patients into subgroups with CPB urine output below and over 4 mL/kg/h, it was identified as an independent predictor for AKI with the odds ratio of 0.43 (confidence interval 0.30–0.61) and 1.11 (confidence interval 1.02–1.20), respectively. The amount of urine output during CPB with careful analysis may serve as a simple and feasible method to predict the development of AKI after cardiac surgery at an early time point. PMID:27258505

  5. Caveolae protect endothelial cells from membrane rupture during increased cardiac output

    PubMed Central

    Cheng, Jade P.X.; Mendoza-Topaz, Carolina; Howard, Gillian; Chadwick, Jessica; Shvets, Elena; Cowburn, Andrew S.; Dunmore, Benjamin J.; Crosby, Alexi; Morrell, Nicholas W.

    2015-01-01

    Caveolae are strikingly abundant in endothelial cells, yet the physiological functions of caveolae in endothelium and other tissues remain incompletely understood. Previous studies suggest a mechanoprotective role, but whether this is relevant under the mechanical forces experienced by endothelial cells in vivo is unclear. In this study we have sought to determine whether endothelial caveolae disassemble under increased hemodynamic forces, and whether caveolae help prevent acute rupture of the plasma membrane under these conditions. Experiments in cultured cells established biochemical assays for disassembly of caveolar protein complexes, and assays for acute loss of plasma membrane integrity. In vivo, we demonstrate that caveolae in endothelial cells of the lung and cardiac muscle disassemble in response to acute increases in cardiac output. Electron microscopy and two-photon imaging reveal that the plasma membrane of microvascular endothelial cells in caveolin 1−/− mice is much more susceptible to acute rupture when cardiac output is increased. These data imply that mechanoprotection through disassembly of caveolae is important for endothelial function in vivo. PMID:26459598

  6. At high cardiac output, diesel exhaust exposure increases pulmonary vascular resistance and decreases distensibility of pulmonary resistive vessels.

    PubMed

    Wauters, Aurélien; Vicenzi, Marco; De Becker, Benjamin; Riga, Jean-Philippe; Esmaeilzadeh, Fatemeh; Faoro, Vitalie; Vachiéry, Jean-Luc; van de Borne, Philippe; Argacha, Jean-François

    2015-12-15

    Air pollution has recently been associated with the development of acute decompensated heart failure, but the underlying biological mechanisms remain unclear. A pulmonary vasoconstrictor effect of air pollution, combined with its systemic effects, may precipitate decompensated heart failure. The aim of the present study was to investigate the effects of acute exposure to diesel exhaust (DE) on pulmonary vascular resistance (PVR) under resting and stress conditions but also to determine whether air pollution may potentiate acquired pulmonary hypertension. Eighteen healthy male volunteers were exposed to ambient air (AA) or dilute DE with a particulate matter of <2.5 μm concentration of 300 μg/m(3) for 2 h in a randomized, crossover study design. The effects of DE on PVR, on the coefficient of distensibilty of pulmonary vessels (α), and on right and left ventricular function were evaluated at rest (n = 18), during dobutamine stress echocardiography (n = 10), and during exercise stress echocardiography performed in hypoxia (n = 8). Serum endothelin-1 and fractional exhaled nitric oxide were also measured. At rest, exposure to DE did not affect PVR. During dobutamine stress, the slope of the mean pulmonary artery pressure-cardiac output relationship increased from 2.8 ± 0.5 mmHg · min · l (-1) in AA to 3.9 ± 0.5 mmHg · min · l (-1) in DE (P < 0.05) and the α coefficient decreased from 0.96 ± 0.15 to 0.64 ± 0.12%/mmHg (P < 0.01). DE did not further enhance the hypoxia-related upper shift of the mean pulmonary artery pressure-cardiac output relationship. Exposure to DE did not affect serum endothelin-1 concentration or fractional exhaled nitric oxide. In conclusion, acute exposure to DE increased pulmonary vasomotor tone by decreasing the distensibility of pulmonary resistive vessels at high cardiac output. PMID:26497960

  7. Low Cardiac Output Leads Hepatic Fibrosis in Right Heart Failure Model Rats

    PubMed Central

    Fujimoto, Yoshitaka; Urashima, Takashi; Shimura, Daisuke; Ito, Reiji; Kawachi, Sadataka; Kajimura, Ichige; Akaike, Toru; Kusakari, Yoichiro; Fujiwara, Masako; Ogawa, Kiyoshi; Goda, Nobuhito; Ida, Hiroyuki; Minamisawa, Susumu

    2016-01-01

    Background Hepatic fibrosis progresses with right heart failure, and becomes cardiac cirrhosis in a severe case. Although its causal factor still remains unclear. Here we evaluated the progression of hepatic fibrosis using a pulmonary artery banding (PAB)-induced right heart failure model and investigated whether cardiac output (CO) is responsible for the progression of hepatic fibrosis. Methods and Results Five-week-old Sprague-Dawley rats divided into the PAB and sham-operated control groups. After 4 weeks from operation, we measured CO by echocardiography, and hepatic fibrosis ratio by pathological examination using a color analyzer. In the PAB group, CO was significantly lower by 48% than that in the control group (78.2±27.6 and 150.1±31.2 ml/min, P<0.01). Hepatic fibrosis ratio and serum hyaluronic acid, an index of hepatic fibrosis, were significantly increased in the PAB group than those in the control group (7.8±1.7 and 1.0±0.2%, P<0.01, 76.2±27.5 and 32.7±7.5 ng/ml, P<0.01). Notably, the degree of hepatic fibrosis significantly correlated a decrease in CO. Immunohistological analysis revealed that hepatic stellate cells were markedly activated in hypoxic areas, and HIF-1α positive hepatic cells were increased in the PAB group. Furthermore, by real-time PCR analyses, transcripts of profibrotic and fibrotic factors (TGF-β1, CTGF, procollargen I, procollargen III, MMP 2, MMP 9, TIMP 1, TIMP 2) were significantly increased in the PAB group. In addition, western blot analyses revealed that the protein level of HIF-1α was significantly increased in the PAB group than that in the control group (2.31±0.84 and 1.0±0.18 arbitrary units, P<0.05). Conclusions Our study demonstrated that low CO and tissue hypoxia were responsible for hepatic fibrosis in right failure heart model rats. PMID:26863419

  8. Acupuncture effects on cardiac functions measured by cardiac magnetic resonance imaging in a feline model.

    PubMed

    Lin, Jen-Hsou; Shih, Chen-Haw; Kaphle, Krishna; Wu, Leang-Shin; Tseng, Weng-Yih; Chiu, Jen-Hwey; Lee, Tzu-Chi; Wu, Ying-Ling

    2010-06-01

    The usefulness of acupuncture (AP) as a complementary and/or alternative therapy in animals is well established but more research is needed on its clinical efficacy relative to conventional therapy, and on the underlying mechanisms of the effects of AP. Cardiac magnetic resonance imaging (CMRI), an important tool in monitoring cardiovascular diseases, provides a reliable method to monitor the effects of AP on the cardiovascular system. This controlled experiment monitored the effect electro-acupuncture (EA) at bilateral acupoint Neiguan (PC6) on recovery time after ketamine/xylazine cocktail anesthesia in healthy cats. The CMRI data established the basic feline cardiac function index (CFI), including cardiac output and major vessel velocity. To evaluate the effect of EA on the functions of the autonomic nervous and cardiovascular systems, heart rate, respiration rate, electrocardiogram and pulse rate were also measured. Ketamine/xylazine cocktail anesthesia caused a transient hypertension in the cats; EA inhibited this anesthetic-induced hypertension and shortened the post-anesthesia recovery time. Our data support existing knowledge on the cardiovascular benefits of EA at PC6, and also provide strong evidence for the combination of anesthesia and EA to shorten post-anesthesia recovery time and counter the negative effects of anesthetics on cardiac physiology. PMID:18955311

  9. Beat-by-beat analysis of cardiac output and blood pressure responses to short-term barostimulation in different body positions

    NASA Astrophysics Data System (ADS)

    Hildebrandt, Wulf; Schütze, Harald; Stegemann, J.

    Rapid quantification of the human baro-reflex control of heart rate has been achieved on a beat-by-beat basis using a neck-chamber with quick ECG-triggered pressure changes. Referring to recent findings on heart rate and stroke volume, the present study uses this technique to compare cardiac output as well as blood pressure changes in supine and upright position to investigate feedback effects and to confirm postural reflex modifications not revealed by RR-interval changes. A suction profile starting at +40 mmHg and running 7 steps of pressure decrease down to -65 mmHg was examined in 0° and 90° tilting position while beat-by-beat recordings were done of heart rate, stroke volume (impedance-cardiography) and blood pressure (Finapres tm) (n=16). The percentual heart rate decrease failed to be significantly different between positions. A suction-induced stroke volume increase led to a cardiac output almost maintained when supine and significantly increased when upright. A decrease in all blood pressure values was found during suction, except for systolic values in upright position which increased. Conclusively, (a) it is confirmed that different inotropy accounts for the seen gravitational effect on the cardiac output not represented by heart rate; (b) identical suction levels in different positions lead to different stimuli at the carotid receptor. This interference has to be considered in microgravity studies by beat-by-beat measurement of cardiac output and blood pressure.

  10. Bioreactance: a new tool for cardiac output and thoracic fluid content monitoring during hemodialysis.

    PubMed

    Kossari, Niloufar; Hufnagel, Gilles; Squara, Pierre

    2009-10-01

    Outpatient hemodialysis therapy (HD) can be associated with hemodynamic compromise. Bioreactance has recently been shown to provide accurate, noninvasive, continuous, measurements of cardiac output (CO) and thoracic impedance (Zo) from which thoracic fluid content (TFC) can be derived assuming TFC=1000/Zo. This study was designed to evaluate the changes in TFC in comparison with the traditional indices of fluid removal (FR) and to understand the trends in CO changes in HD patients. Minute-by-minute changes in TFC and CO were prospectively collected using the bioreactance system (NICOM) in HD patients of a single unit. Changes in body weight (DeltaW), hematocrit (DeltaHct), and amount of FR were also measured. Twenty-five patients (age 77 +/- 11 years) were included. The TFC decreased in all patients by an average of 5.4 +/- 7.9 kohm(-1), weight decreased by 1.48 +/- 0.98 kg, and FR averaged 2.07 +/- 1.93 L over a 3- to 4-hour HD session. There were good correlations between DeltaTFC and DeltaW (R=0.80, P<0.0001) and FR (R=0.85, P<0.0001). DeltaHct (4.13 +/- 3.42%) was poorly correlated with DeltaTFC (R=0.35, P=0.12) and FR (R=0.40, P=0.07). The regression line between FR and TFC yielded FR=1.0024-0.1985TFC; thus, a 1 kohm(-1) change of Zo correlates with an approximately 200 mL change in total body water. The change in CO (-0.52 +/- 0.49 L/min m(2)) during HD did not correlate with FR (R=0.15, P=NS). Changes in TFC represented the monitored variable most closely related to FR. CO remained fairly constant in this stable patient cohort. Further studies in high-risk patients are warranted to understand whether TFC and CO monitoring can improve HD session management. PMID:19758300

  11. Jet and ultrasonic nebuliser output: use of a new method for direct measurement of aerosol output.

    PubMed Central

    Dennis, J H; Stenton, S C; Beach, J R; Avery, A J; Walters, E H; Hendrick, D J

    1990-01-01

    Output from jet nebulisers is calibrated traditionally by weighing them before and after nebulisation, but the assumption that the weight difference is a close measure of aerosol generation could be invalidated by the concomitant process of evaporation. A method has been developed for measuring aerosol output directly by using a solute (fluoride) tracer and aerosol impaction, and this has been compared with the traditional weight loss method for two Wright, six Turbo, and four Micro-Cirrus jet nebulisers and two Microinhaler ultrasonic nebulisers. The weight loss method overestimated true aerosol output for all jet nebulisers. The mean aerosol content, expressed as a percentage of the total weight loss, varied from as little as 15% for the Wright jet nebulisers to 54% (range 45-61%) for the Turbo and Micro-Cirrus jet nebulisers under the operating conditions used. In contrast, there was no discrepancy between weight loss and aerosol output for the ultrasonic nebulisers. These findings, along with evidence of both concentrating and cooling effects from jet nebulisation, confirm that total output from jet nebulisers contains two distinct fractions, vapour and aerosol. The vapour fraction, but not the aerosol fraction, was greatly influenced by reservoir temperature within the nebuliser; so the ratio of aerosol output to total weight loss varied considerably with temperature. It is concluded that weight loss is an inappropriate method of calibrating jet nebuliser aerosol output, and that this should be measured directly. PMID:2247862

  12. The effects on arterial haemoglobin oxygen saturation and on shunt of increasing cardiac output with dopamine or dobutamine during one-lung ventilation.

    PubMed

    Russell, W J; James, M F

    2004-10-01

    Theoretically, if the cardiac output were increased in the presence of a given intrapulmonary shunt, the arterial saturation should improve as the venous oxygen extraction per ml of blood decreases if the total oxygen consumption remains constant. Previous work demonstrated that this was not achieved with adrenaline or isoprenaline as increased shunting negated any benefit from improved cardiac output and mixed venous oxygen content. However pharmacological stimulation of cardiac output and venous oxygen without any increase in shunt should achieve the goal of improved arterial oxygenation. To test this hypothesis, seven pigs were subjected to one-lung ventilation and infused on separate occasions, with dopamine and with dobutamine in random order to increase the cardiac output. The mixed venous oxygen content, shunt fraction, oxygen consumption and arterial oxygen saturation were measured. With both dopamine and dobutamine there was a consistent rise in venous oxygen content. However, with dopamine, the mean shunt rose from 28% to 42% and with dobutamine, the mean shunt rose from 45% to 59% (both changes P<0.01). With dopamine, the mean arterial oxygen saturation fell by 4.7%, and with dobutamine by 2.9%, but neither fall was statistically significant. It is concluded that any benefit to arterial saturation which might occur from a dopamine- or dobutamine-induced increase in mixed venous oxygen content during one-lung ventilation is offset by increased shunting. During one-lung anaesthesia, there would appear to be no benefit to arterial saturation in increasing cardiac output with an infusion of either dopamine or dobutamine. PMID:15535486

  13. Taking the Measure: Applying Reference Outputs to Collection Development.

    ERIC Educational Resources Information Center

    Moore, Carolyn M.; Mielke, Linda

    1986-01-01

    Presents preliminary results of Clearwater Public Library's study of the usefulness of "Output Measures for Public Libraries" as an indicator of reference performance, and the impact of collection development choices on reference output measures. Data on turnover rate, in-library use, reference fill rate, and reference transactions per capita are…

  14. Cooperative linear output regulation for networked systems by dynamic measurement output feedback

    NASA Astrophysics Data System (ADS)

    Li, Shaobao; Feng, Gang; Wang, Juan; Luo, Xiaoyuan; Guan, Xinping

    2016-04-01

    This paper investigates the cooperative linear output regulation problem of a class of heterogeneous networked systems with a common reference input but with different disturbances for individual nodes. A novel distributed control law is presented based on dynamic measurement output feedback. It is shown that the overall networked closed-loop control system is asymptotically stable and the output regulation errors asymptotically approach zero as time goes to infinity under a sufficient and necessary condition. Finally, a numerical example is provided to demonstrate the effectiveness of the proposed control law.

  15. Low Cardiac Output Secondary to a Malpositioned Umbilical Venous Catheter: Value of Targeted Neonatal Echocardiography

    PubMed Central

    Weisz, Dany E.; Poon, Wei Bing; James, Andrew; McNamara, Patrick J.

    2014-01-01

    Systemic hypotension is common in very low birthweight preterm infants but the nature of the precipitating cause may be unclear. Targeted neonatal echocardiography (TnEcho) is being increasingly used to support hemodynamic decisions in the neonatal intensive care unit (NICU), including identifying impairments in the transitional circulation of preterm infants, providing timely re-evaluation after institution of therapies and evaluating the placement of indwelling catheters. We present a case of a preterm infant with systemic hypotension and low cardiac output secondary to a large transatrial shunt induced by a malpositioned umbilical venous catheter. Repositioning of the line led to resolution of the hemodynamic disturbance and clinical instability, highlighting the utility of TnEcho in the NICU. PMID:25032055

  16. Noninvasive aortic bloodflow by Pulsed Doppler Echocardiography (PDE) compared to cardiac output by the direct Fick procedure

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Left ventricular stroke volume was estimated from the systolic velocity integral in the ascending aorta by pulsed Doppler Echocardiography (PDE) and the cross sectional area of the aorta estimated by M mode echocardiography on 15 patients with coronary disease undergoing right catheterization for diagnostic purposes. Cardiac output was calculated from stroke volume and heart volume using the PDE method as well as the Fick procedure for comparison. The mean value for the cardiac output via the PDE method (4.42 L/min) was only 6% lower than for the cardiac output obtained from the Fick procedure (4.69 L/min) and the correlation between the two methods was excellent (r=0.967, p less than .01). The good agreement between the two methods demonstrates that the PDE technique offers a reliable noninvasive alternative for estimating cardiac output, requiring no active cooperation by the subject. It was concluded that the Doppler method is superior to the Fick method in that it provides beat by beat information on cardiac performance.

  17. Against Journal Articles for Measuring Value in University Output

    ERIC Educational Resources Information Center

    Mbali, C.

    2010-01-01

    The following lines of arguments against the metrics of journal articles is developed: (1) Textual output should no longer be main valued output; (2) Digitalization enables other ways of advancing knowledge; (3) Measures by journal article favours the disciplines of Natural Science and Engineering (NSE) and moulds other disciplines of Social…

  18. Clinical significance of a spiral phenomenon in the plot of CO₂ output versus O₂ uptake during exercise in cardiac patients.

    PubMed

    Nagayama, Osamu; Koike, Akira; Himi, Tomoko; Sakurada, Koji; Kato, Yuko; Suzuki, Shinya; Sato, Akira; Yamashita, Takeshi; Wasserman, Karlman; Aonuma, Kazutaka

    2015-03-01

    A spiral phenomenon is sometimes noted in the plots of CO₂ output (VCO₂) against O₂ uptake (VO₂) measured during cardiopulmonary exercise testing (CPX) in patients with heart failure with oscillatory breathing. However, few data are available that elucidate the clinical significance of this phenomenon. Our group studied the prevalence of this phenomenon and its relation to cardiac and cardiopulmonary function. Of 2,263 cardiac patients who underwent CPX, 126 patients with a clear pattern of oscillatory breathing were identified. Cardiopulmonary indexes were compared between patients who showed the spiral phenomenon (n = 49) and those who did not (n = 77). The amplitudes of VO₂ and VCO₂ oscillations were greater and the phase difference between VO₂ and VCO₂ oscillations was longer in the patients with the spiral phenomenon than in those without it. Patients with the spiral phenomenon also had a lower left ventricular ejection fraction (43.4 ± 21.4% vs 57.1 ± 16.8%, p <0.001) and a higher level of brain natriuretic peptide (637.2 ± 698.3 vs 228.3 ± 351.4 pg/ml, p = 0.002). The peak VO₂ was lower (14.5 ± 5.6 vs 18.1 ± 6.3, p = 0.002), the slope of the increase in ventilation versus VCO₂ was higher (39.8 ± 9.5 vs 33.6 ± 6.8, p <0.001), and end-tidal PCO₂ both at rest and at peak exercise was lower in the patients with the spiral phenomenon than in those without it. In conclusion, the spiral phenomenon in the VCO₂-versus-VO₂ plot arising from the phase difference between VCO₂ and VO₂ oscillations reflects more advanced cardiopulmonary dysfunction in cardiac patients with oscillatory breathing. PMID:25591892

  19. Classification of hospitals based on measured output: the VA system.

    PubMed

    Thomas, J W; Berki, S E; Wyszewianski, L; Ashcraft, M L

    1983-07-01

    Evaluation of hospital performance and improvement of resource allocation in hospital systems require a method for classifying hospitals on the basis of their output. Previous approaches to hospital classification relied largely on input characteristics. The authors propose and apply a procedure for classifying hospitals into groups where within-group hospitals are similar with respect to output. Direct measures of case-mix-adjusted discharges and outpatient visits are the principal measures of patient care output; other measures capture training and research functions. The component measures were weighted, and a composite output measure was calculated for each of the 162 hospitals in the Veterans Administration health care system. The output score then was used as the dependent variable in an Automatic Interaction Detector analysis, which partitioned the 162 hospitals into 10 groups, accounting for 85 per cent of the variance in the dependent variable. An extension of the output classification method is presented for illustration of how the difference between hospitals' actual operating costs and costs predicted on the basis of output can be used in defining isoefficiency groups. PMID:6350744

  20. Comparison of cardiac output of the left and right side of the heart by ultrafast computed tomography

    SciTech Connect

    Wolfkiel, C.J.; Ferguson, J.L.; Law, W.R.; Chomka, E.V.; Brundage, B.H.

    1986-03-05

    Ultrafast computed tomography (CT) evaluation of cardiac output (CO) can be determined using indicator dilution theory. The concentration of an iodinated contrast agent injected into a vein of a subject can be measured as a function of time by serial EKG, gated CT imaging. The contrast density of the blood pool measured by CT defines the indicator concentration. CT CO is proportional to the area under a time density curve from a region of the blood pool. Proper subject position and scanning timing allows CT to measure CO in the pulmonary (PA) artery and the aorta (AO) with the same contrast bolus. Three anesthetized dogs were multiply scanned following simultaneous injections of contrast and radioactive tracer microspheres. Microsphere CO was determined by reference withdrawal method. Multiple thermodilution CO measurements were made just prior and after each CT CO procedure. 24 comparisons were made of thermodilution, microsphere and CT CO measured in the PA (right sided CO (RSCO)) and the AO (left sided CO (LSCO)). CT CO was calculated as the ratio of the volume of contrast injected to the time density curve area corrected for the relation of contrast density to CT number. RSCO agreed very closely to LSCO (r = .99, p < .001; y = 1.0x +/- .32). RSCO correlated to thermodilution (r = .96, p < .001; y = 1.2x +/- 1.3) and microsphere CO (r = .93, p < .001; y = .69x +/- 1.3). These data show that CT CO measurements can be made in the PA and AO with equal accuracy.

  1. Pulse contour analysis: Is it able to reliably detect changes in cardiac output in the haemodynamically unstable patient?

    PubMed Central

    2011-01-01

    Three pulse contour systems for monitoring cardiac output - LiDCO Plus™, PiCCO Plus™ and FloTrac™ - were compared in postcardiac surgery patients. None of the three methods demonstrated good trending ability according to concordance analysis. Pulse contour systems remain unreliable in the haemodynamically unstable patient. PMID:21349140

  2. Use of electroconvulsive therapy in an elderly after 5 weeks of myocardial infraction with 30% cardiac output.

    PubMed

    Grover, Sandeep; Suchendra, K; Mehra, Aseem; Parkash, Vijay; Saini, Vikas; Bagga, Shiv

    2015-01-01

    There is limited literature on the use of electroconvulsive therapy (ECT) in patients with recent myocardial infarction and in those with reduced cardiac output. In this report, we describe the safe use of ECT in a 70-year-male suffering from severe depressive episode with psychotic symptoms. He had a history of poor response to adequate pharmacotherapy and had suffered from myocardial infraction (MI), about 3 weeks prior to admission to the psychiatric unit. In view of severe depression associated with marked anxiety, agitation, psychotic symptoms, and poor food intake he was started on ECT after 5 weeks of MI when his cardiac output was only 30%. He received nine sessions of ECT without any cardiac complications and his depression remitted with ECT. PMID:27212828

  3. Left ventricular atrioventricular plane displacement is preserved with lifelong endurance training and is the main determinant of maximal cardiac output.

    PubMed

    Steding-Ehrenborg, Katarina; Boushel, Robert C; Calbet, José A; Åkeson, Per; Mortensen, Stefan P

    2015-12-01

    Age-related decline in cardiac function can be prevented or postponed by lifelong endurance training. However, effects of normal ageing as well as of lifelong endurance exercise on longitudinal and radial contribution to stroke volume are unknown. The aim of this study was to determine resting longitudinal and radial pumping in elderly athletes, sedentary elderly and young sedentary subjects. Furthermore, we aimed to investigate determinants of maximal cardiac output in elderly. Eight elderly athletes (63 ± 4 years), seven elderly sedentary (66 ± 4 years) and ten young sedentary subjects (29 ± 4 years) underwent cardiac magnetic resonance imaging. All subjects underwent maximal exercise testing and for elderly subjects maximal cardiac output during cycling was determined using a dye dilution technique. Longitudinal and radial contribution to stroke volume did not differ between groups (longitudinal left ventricle (LV) 52-65%, P = 0.12, right ventricle (RV) 77-87%, P = 0.16, radial 7.9-8.6%, P = 1.0). Left ventricular atrioventricular plane displacement (LVAVPD) was higher in elderly athletes and young sedentary compared with elderly sedentary subjects (14 ± 3, 15 ± 2 and 11 ± 1 mm, respectively, P < 0.05). There was no difference between groups for RVAVPD (P = 0.2). LVAVPD was an independent predictor of maximal cardiac output (R(2) = 0.61, P < 0.01, β = 0.78). Longitudinal and radial contributions to stroke volume did not differ between groups. However, how longitudinal pumping was achieved differed; elderly athletes and young sedentary subjects showed similar AVPD whereas this was significantly lower in elderly sedentary subjects. Elderly sedentary subjects achieved longitudinal pumping through increased short-axis area of the ventricle. Large AVPD was a determinant of maximal cardiac output and exercise capacity. PMID:26496146

  4. Femoral Blood Flow and Cardiac Output During Blood Flow Restricted Leg Press Exercise

    NASA Technical Reports Server (NTRS)

    Everett, M. E.; Hackney, K.; Ploutz-Snyder, L.

    2011-01-01

    Low load blood flow restricted resistance exercise (LBFR) causes muscle hypertrophy that may be stimulated by the local ischemic environment created by the cuff pressure. However, local blood flow (BF) during such exercise is not well understood. PURPOSE: To characterize femoral artery BF and cardiac output (CO) during leg press exercise (LP) performed at a high load (HL) and low load (LL) with different levels of cuff pressure. METHODS: Eleven subjects (men/women 4/7, age 31.4+/-12.8 y, weight 68.9+/-13.2 kg, mean+/-SD) performed 3 sets of supine left LP to fatigue with 90 s of rest in 4 conditions: HL (%1-RM/cuff pressure: 80%/0); LL (20%/0); LBFR(sub DBP) (20%/1.3 x diastolic blood pressure, BP); LBFR(sub SBP) (20%/1.3 x supine systolic BP). The cuff remained inflated throughout the LBFR exercise sessions. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using Doppler ultrasound at rest and immediately after each set of exercise. Heart rate (HR) was monitored using a 3-lead ECG. BF was calculated as VTI x vessel cross-sectional area. CO was calculated as HR x SV. The data obtained after each set of exercise were averaged and used for analyses. Multi-level modeling was used to determine the effect of exercise condition on dependent variables. Statistical significance was set a priori at p< 0.05. RESULTS: Artery diameter did not change from baseline. BF increased (p<0.05) after exercise in each condition except LBFR(sub SBP) in the order of HL (12.73+/-1.42 cm3,mean+/-SE) > LL (9.92+/-0.82 cm3) > LBFR(sub dBP)(6.47+/-0.79 cm3) > LBFR(sub SBP) (3.51+/-0.59 cm3). Blunted exercise induced increases occurred in HR, SV, and CO after LBFR compared to HL and LL. HR increased 45% after HL and LL and 28% after LBFR (p<0.05), but SV increased (p<0.05) only after HL. Consequently, the increase (p<0.05) in CO was greater in HL and LL (approximately 3 L/min) than in LBFR (approximately 1 L/min). CONCLUSION: BF during LBFR(sub SBP) was 1/3 of

  5. Influence of water immersion, water gymnastics and swimming on cardiac output in patients with heart failure

    PubMed Central

    Schmid, Jean‐Paul; Noveanu, Markus; Morger, Cyrill; Gaillet, Raymond; Capoferri, Mauro; Anderegg, Matthias; Saner, Hugo

    2007-01-01

    Background Whole‐body water immersion leads to a significant shift of blood from the periphery to the intrathoracic circulation, followed by an increase in central venous pressure and heart volume. In patients with severely reduced left ventricular function, this hydrostatically induced volume shift might overstrain the cardiovascular adaptive mechanisms and lead to cardiac decompensation. Aim To assess the haemodynamic response to water immersion, gymnastics and swimming in patients with chronic heart failure (CHF). Methods 10 patients with compensated CHF (62.9 (6.3) years, ejection fraction 31.5% (4.1%), peak oxygen consumption (V̇o2) 19.4 (2.8) ml/kg/min), 10 patients with coronary artery disease (CAD) but preserved left ventricular function (57.2 (5.6) years, ejection fraction 63.9% (5.5%), peak V̇o2 28 (6.3) ml/kg/min), and 10 healthy controls (32.8 (7.2) years, peak V̇o2 45.6 (6) ml/kg/min) were examined. Haemodynamic response to thermoneutral (32°C) water immersion and exercise was measured using a non‐invasive foreign gas rebreathing method during stepwise water immersion, water gymnastics and swimming. Results Water immersion up to the chest increased cardiac index by 19% in controls, by 21% in patients with CAD and by 16% in patients with CHF. Although some patients with CHF showed a decrease of stroke volume during immersion, all subjects were able to increase cardiac index (by 87% in healthy subjects, by 77% in patients with CAD and by 53% in patients with CHF). V̇o2 during swimming was 9.7 (3.3) ml/kg/min in patients with CHF, 12.4 (3.5) ml/kg/min in patients with CAD and 13.9 (4) ml/kg/min in controls. Conclusions Patients with severely reduced left ventricular function but stable clinical conditions and a minimal peak V̇o2 of at least 15 ml/kg/min during a symptom‐limited exercise stress test tolerate water immersion and swimming in thermoneutral water well. Although cardiac index and V̇o2 are lower than in patients

  6. Noninvasive ambulatory measurement system of cardiac activity.

    PubMed

    Pino, Esteban J; Chavez, Javier A P; Aqueveque, Pablo

    2015-08-01

    This work implements a noninvasive system that measures the movements caused by cardiac activity. It uses unobtrusive Electro-Mechanical Films (EMFi) on the seat and on the backrest of a regular chair. The system detects ballistocardiogram (BCG) and respiration movements. Real data was obtained from 54 volunteers. 19 of them were measured in the laboratory and 35 in a hospital waiting room. Using a BIOPAC acquisition system, the ECG was measured simultaneously to the BCG for comparison. Wavelet Transform (WT) is a better option than Empirical Mode Decomposition (EMD) for signal extraction and produces higher effective measurement time. In the laboratory, the best results are obtained on the seat. The correlation index was 0.9800 and the Bland-Altman limits of agreement were 0.7136 ± 4.3673 [BPM]. In the hospital waiting room, the best results are also from the seat sensor. The correlation index was 0.9840, and the limits of agreement were 0.4386 ± 3.5884 [BPM]. The system is able to measure BCG in an unobtrusive way and determine the cardiac frequency with high precision. It is simple to use, which means the system can easily be used in non-standard settings: resting in a chair or couch, at the gym, schools or in a hospital waiting room, as shown. PMID:26738057

  7. A computational model-based validation of Guyton's analysis of cardiac output and venous return curves

    NASA Technical Reports Server (NTRS)

    Mukkamala, R.; Cohen, R. J.; Mark, R. G.

    2002-01-01

    Guyton developed a popular approach for understanding the factors responsible for cardiac output (CO) regulation in which 1) the heart-lung unit and systemic circulation are independently characterized via CO and venous return (VR) curves, and 2) average CO and right atrial pressure (RAP) of the intact circulation are predicted by graphically intersecting the curves. However, this approach is virtually impossible to verify experimentally. We theoretically evaluated the approach with respect to a nonlinear, computational model of the pulsatile heart and circulation. We developed two sets of open circulation models to generate CO and VR curves, differing by the manner in which average RAP was varied. One set applied constant RAPs, while the other set applied pulsatile RAPs. Accurate prediction of intact, average CO and RAP was achieved only by intersecting the CO and VR curves generated with pulsatile RAPs because of the pulsatility and nonlinearity (e.g., systemic venous collapse) of the intact model. The CO and VR curves generated with pulsatile RAPs were also practically independent. This theoretical study therefore supports the validity of Guyton's graphical analysis.

  8. High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old.

    PubMed

    Teomete, Uygar; Gugol, Rubee Anne; Neville, Holly; Dandin, Ozgur; Young, Ming-Lon

    2016-01-01

    Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics. PMID:26885434

  9. Diltiazem restores cardiac output and improves renal function after hemorrhagic shock and crystalloid resuscitation.

    PubMed

    Wang, P; Ba, Z F; Meldrum, D R; Chaudry, I H

    1992-05-01

    Although calcium antagonists produce salutary effects after shock and ischemia, it is unknown whether such agents restore the depressed cardiac output (CO) and renal function in a nonheparinized model of trauma-hemorrhage and resuscitation. To study this, rats underwent a midline laparotomy (i.e., trauma induced) and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of the maximum bleedout was returned in the form of Ringer lactate (RL). They were then resuscitated with four times the volume of shed blood with RL over 60 min. Diltiazem (400 micrograms/kg body wt) or an equal volume of saline was infused intravenously over 95 min. This infusion was started during the last 15 min of resuscitation. CO was determined by indocyanine green dilution. Glomerular filtration rate (GFR) was assessed with [3H]inulin clearance, and cortical microcirculation was examined by laser Doppler flowmetry. Results indicate that crystalloid resuscitation alone transiently restored but did not maintain CO after hemorrhage. Diltiazem infusion in conjunction with crystalloid resuscitation, however, restored and maintained CO and cortical microcirculation. Although GFR decreased in both groups, the values in diltiazem-treated animals were significantly higher than those in the sham-operated animals. Furthermore, diltiazem markedly decreased tissue water content. Thus diltiazem appears to be a promising adjunct in the treatment of hemorrhagic shock even in the absence of blood resuscitation. PMID:1590448

  10. High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old

    PubMed Central

    Teomete, Uygar; Gugol, Rubee Anne; Neville, Holly; Dandin, Ozgur; Young, Ming-Lon

    2016-01-01

    Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics. PMID:26885434

  11. May-Thurner syndrome: High output cardiac failure as a result of iatrogenic iliac fistula

    PubMed Central

    Singh, Shantanu; Singh, Shivank; Jyothimallika, Juthika; Lynch, Teresa J

    2015-01-01

    May-Thurner syndrome (MTS) also termed iliocaval compression or Cockett-Thomas syndrome is a common, although rarely diagnosed, condition in which the patient has an anatomical variant wherein the right common iliac artery overlies and compresses the left common iliac vein against the fifth lumbar spine resulting in increased risk of iliofemoral deep venous thrombosis. This variant has been shown to be present in over 23% of the population but most go undetected. We present a patient with MTS who developed high output cardiac failure due to an iatrogenic iliac fistula. The patient underwent an extensive workup for a left to right shunt including MRI and arterial duplex in the vascular lab. He was ultimately found to have a 2.1 cm left common iliac artery aneurysm and history of common iliac stent. We took the patient to the operating room for aortogram with placement of an endovascular plug of the left internal iliac artery and aorto-bi-iliac stent graft placement with CO2 and IV contrast. Subsequently the patient underwent successful stent placement in the area that was compressed followed by 6 mo of anticoagulation with warfarin. The flow from the fistula decreased significantly. PMID:25789305

  12. PRESAGE 3D dosimetry accurately measures Gamma Knife output factors

    NASA Astrophysics Data System (ADS)

    Klawikowski, Slade J.; Yang, James N.; Adamovics, John; Ibbott, Geoffrey S.

    2014-12-01

    Small-field output factor measurements are traditionally very difficult because of steep dose gradients, loss of lateral electronic equilibrium, and dose volume averaging in finitely sized detectors. Three-dimensional (3D) dosimetry is ideal for measuring small output factors and avoids many of these potential challenges of point and 2D detectors. PRESAGE 3D polymer dosimeters were used to measure the output factors for the 4 mm and 8 mm collimators of the Leksell Perfexion Gamma Knife radiosurgery treatment system. Discrepancies between the planned and measured distance between shot centers were also investigated. A Gamma Knife head frame was mounted onto an anthropomorphic head phantom. Special inserts were machined to hold 60 mm diameter, 70 mm tall cylindrical PRESAGE dosimeters. The phantom was irradiated with one 16 mm shot and either one 4 mm or one 8 mm shot, to a prescribed dose of either 3 Gy or 4 Gy to the 50% isodose line. The two shots were spaced between 30 mm and 60 mm apart and aligned along the central axis of the cylinder. The Presage dosimeters were measured using the DMOS-RPC optical CT scanning system. Five independent 4 mm output factor measurements fell within 2% of the manufacturer’s Monte Carlo simulation-derived nominal value, as did two independent 8 mm output factor measurements. The measured distances between shot centers varied by ±0.8 mm with respect to the planned shot displacements. On the basis of these results, we conclude that PRESAGE dosimetry is excellently suited to quantify the difficult-to-measure Gamma Knife output factors.

  13. Combined first pass and gated blood pool radionuclide studies in the hemodynamic-cardiac evaluation of patients with low cardiac output

    SciTech Connect

    Abi-Mansour, P.; Fouad, F.M.; Sheeler, L.R.; Bravo, E.L.; MacIntyre, W.J.; Tarazi, R.C.

    1984-01-01

    Cardiac output (CO) is frequently used in the evaluation of cardiac function but low CO does not necessarily reflect heart failure. Similarly, low ejection fraction (EF) can be present in compensated heart diseases. In order to evaluate cardiac performance in relation to systematic hemodynamics, the authors used a multifactorial approach for the determination of CO, EF, pulmonary mean transit time (MTT), ratio of cardiopulmonary volume over total blood volume (CPV/TBV as an index of venous tone) all obtained from a single injection of 99m Tc-HSA. Four different conditions associated with low CO (less than or equal to 2.1 L/min/m/sup 2/) were evaluated. The combined use of CO, EF, MTT and CPV/TBV allowed a better understanding of the myocardial and peripheral circulatory factors associated with low CO states. This is helpful in the selection and follow-up of appropriate therapeutic intervention.

  14. First in vivo application and evaluation of a novel method for non-invasive estimation of cardiac output.

    PubMed

    Papaioannou, Theodore G; Soulis, Dimitrios; Vardoulis, Orestis; Protogerou, Athanase; Sfikakis, Petros P; Stergiopulos, Nikolaos; Stefanadis, Christodoulos

    2014-10-01

    Surgical or critically ill patients often require continuous assessment of cardiac output (CO) for diagnostic purposes or for guiding therapeutic interventions. A new method of non-invasive CO estimation has been recently developed, which is based on pressure wave analysis. However, its validity has been examined only in silico. Aim of this study was to evaluate in vivo the reproducibility and accuracy of the "systolic volume balance" method (SVB). Twenty two subjects underwent 2-D transthoracic echocardiography for CO measurement (reference value of CO). The application of SVB method required aortic pressure wave analysis and estimation of total arterial compliance. Aortic pulses were derived by mathematical transformation of radial pressure waves recorded by applanation tonometry. Total compliance was estimated by the "pulse pressure" method. The agreement, association, variability, bias and precision between Doppler and SVB measures of CO were evaluated by intraclass correlation coefficient (ICC), mean difference, SD of differences, percentage error (PR) and Bland-Altman analysis. SVB yielded very reproducible CO estimates (ICC=0.84, mean difference 0.27 ± 0.73 L/min, PR = 16.7%). SVB-derived CO was comparable with Doppler measurements, indicating a good agreement and accuracy (ICC = 0.74, mean difference = -0.22 ± 0.364 L/min, PR ≈ 15). The basic mathematical and physical principles of the SVB method provide highly reproducible and accurate estimates of CO compared with echocardiography. PMID:25108554

  15. Dynamic device properties of pulse contour cardiac output during transcatheter aortic valve implantation.

    PubMed

    Petzoldt, Martin; Riedel, Carsten; Braeunig, Jan; Haas, Sebastian; Goepfert, Matthias S; Treede, Hendrik; Baldus, Stephan; Goetz, Alwin E; Reuter, Daniel A

    2015-06-01

    This prospective single-center study aimed to determine the responsiveness and diagnostic performance of continuous cardiac output (CCO) monitors based on pulse contour analysis compared with invasive mean arterial pressure (MAP) during predefined periods of acute circulatory deterioration in patients undergoing transcatheter aortic valve implantation (TAVI). The ability of calibrated (CCO(CAL)) and self-calibrated (CCO(AUTOCAL)) pulse contour analysis to detect the hemodynamic response to 37 episodes of balloon aortic valvuloplasty enabled by rapid ventricular pacing was quantified in 13 patients undergoing TAVI. A "low" and a "high" cut-off limit were predefined as a 15 or 25 % decrease from baseline respectively. We found no significant differences between CCO(CAL) and MAP regarding mean response time [low cut-off: 8.6 (7.1-10.5) vs. 8.9 (7.3-10.8) s, p = 0.76; high cut-off: 11.4 (9.7-13.5) vs. 12.6 (10.7-14.9) s, p = 0.32] or diagnostic performance [area under the receiver operating characteristics curve (AUC): 0.99 (0.98-1.0) vs. 1.0 (0.99-1.0), p = 0.46]. But CCOCAL had a significantly higher amplitude response [95.0 (88.7-98.8) % decrease from baseline] than MAP [41.2 (30.0-52.9) %, p < 0.001]. CCOAUTOCAL had a significantly lower AUC [0.83 (0.73-0.93), p < 0.001] than MAP. Moreover, CCO(CAL) detected hemodynamic recovery significantly earlier than MAP. In conclusion, CCO(CAL) and MAP provided equivalent responsiveness and diagnostic performance to detect acute circulatory depression, whereas CCO(AUTOCAL) appeared to be less appropriate. In contrast to CCO(CAL) the amplitude response of MAP was poor. Consequently even small response amplitudes of MAP could indicate severe decreases in CO. PMID:25355556

  16. Predictors of Post Pericardiotomy Low Cardiac Output Syndrome in Patients With Pericardial Effusion

    PubMed Central

    Sabzi, Feridoun; Faraji, Reza

    2015-01-01

    Introduction: Pathological involvement of pericardium by any disease that resulting in effusion may require decompression and pericardiectomy. The current article describes rare patients with effusion who after pericadiectomy and transient hemodynamic improvement rapidly developed progressive heart failure and subsequent multi organ failure. Methods: During periods of five years, 423 patients in our hospital underwent pericardiotomy for decompression of effusion. The clinical characteristics of those patient with postoperative low cardiac output (B group) (14 cases) recorded and compared with other patients without this postoperative complication (A group) by test and X2. Significant variables in invariables (P≤0.1) entered in logistic regression analysis and odd ratio of these significant variables obtained. Results: Idiopathic pericardial effusion, malignancy, renal failure, connective tissue disease, viral pericarditis was found in 125 patients (27%), 105 patients (25.4%), 65 patients (15.6%), 50 (17.1%) and 10 (2.4%) of patients subsequently. The factors that predict post-operative death in logistic regression analysis were malignancy, radiotherapy, constrictive pericarditis inotropic drug using IABP using, pre-operative EF and pericardial calcification. Conclusion: Certain preoperative variables such as malignancy, radiotherapy, low EF, calcified pericardium and connective tissue disease are associated with POLCOS and post-operative risk of death. This paradoxical response to pericardial decompression may be more frequent than currently appreciated. Its cause may relate to the sudden removal of the chronic external ventricular support from the effusion or thicken pericardium resulting in ventricular dilatation and failure or intra operative myocardial injury due to pericardiectomy of calcified pericardium, radiation and cardiomyopathy. PMID:25859311

  17. Omega-3 fatty acid supplementation enhances stroke volume and cardiac output during dynamic exercise.

    PubMed

    Walser, Buddy; Stebbins, Charles L

    2008-10-01

    Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have beneficial effects on cardiovascular function. We tested the hypotheses that dietary supplementation with DHA (2 g/day) + EPA (3 g/day) enhances increases in stroke volume (SV) and cardiac output (CO) and decreases in systemic vascular resistance (SVR) during dynamic exercise. Healthy subjects received DHA + EPA (eight men, four women) or safflower oil (six men, three women) for 6 weeks. Both groups performed 20 min of bicycle exercise (10 min each at a low and moderate work intensity) before and after DHA + EPA or safflower oil treatment. Mean arterial pressure (MAP), heart rate (HR), SV, CO, and SVR were assessed before exercise and during both workloads. HR was unaffected by DHA + EPA and MAP was reduced, but only at rest (88 +/- 5 vs. 83 +/- 4 mm Hg). DHA + EPA augmented increases in SV (14.1 +/- 6.3 vs. 32.3 +/- 8.7 ml) and CO (8.5 +/- 1.0 vs. 10.3 +/- 1.2 L/min) and tended to attenuate decreases in SVR (-7.0 +/- 0.6 vs. -10.1 +/- 1.6 mm Hg L(-1) min(-1)) during the moderate workload. Safflower oil treatment had no effects on MAP, HR, SV, CO or SVR at rest or during exercise. DHA + EPA-induced increases in SV and CO imply that dietary supplementation with these fatty acids can increase oxygen delivery during exercise, which may have beneficial clinical implications for individuals with cardiovascular disease and reduced exercise tolerance. PMID:18563435

  18. 40 CFR 92.116 - Engine output measurement system calibrations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Engine output measurement system calibrations. 92.116 Section 92.116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Test Procedures §...

  19. Statistics & Input-Output Measures for Colorado Public Libraries, 1997.

    ERIC Educational Resources Information Center

    Seidl, Ann M.

    This document contains statistics and input-output measures for all Colorado public libraries. Tables of the following 1997 survey data are provided: state totals and averages; public library addresses; telephone, fax, and URL for public libraries; public library directors; borrowers, outlets and bookmobiles; ALA-MLS librarians, other staff and…

  20. Statistics & Input-Output Measures for Colorado Public Libraries, 1999.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver. State Library and Adult Education Office.

    "Statistics and Input-Output Measures for Colorado Public Libraries, 1999" is a compilation of data collected from the Colorado Public Library Annual Report sent to each public library jurisdiction in February of 2000 and returned in March. The 1999 response rate was excellent: 100% of Colorado public libraries returned the Annual Report and there…

  1. Heat flow calorimeter. [measures output of Ni-Cd batteries

    NASA Technical Reports Server (NTRS)

    Fletcher, J. C.; Johnston, W. V. (Inventor)

    1974-01-01

    Heat flow calorimeter devices are used to measure heat liberated from or absorbed by an object. This device is capable of measuring the thermal output of sealed nickel-cadmium batteries or cells during charge-discharge cycles. An elongated metal heat conducting rod is coupled between the calorimeter vessel and a heat sink, thus providing the only heat exchange path from the calorimeter vessel itself.

  2. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    PubMed Central

    Auler, José Otavio C.; Torres, Marcelo L. A.; Cardoso, Mônica M.; Tebaldi, Thais C.; Schmidt, André P.; Kondo, Mario M.; Zugaib, Marcelo

    2010-01-01

    BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia. PMID:20835557

  3. Effect of hemorrhage on cardiac output, vasopressin, aldosterone, and diuresis during immersion in men

    NASA Technical Reports Server (NTRS)

    Greenleaf, J. E.; Simanonok, K.; Bernauer, E. M.; Wade, C. E.; Keil, L. C.

    1992-01-01

    The purpose of this research was to test the hypotesis that a reduction in blood volume would attenuate or eliminate immersion-induced increases in cardiac output (Q(sub co)) and urine excretion, and to investigate accompanying vasoactive and fluid-electrolyte hormonal responses. Eight men (19-23 yr) were supine during a 2-hr control period in air, and then sat for 5-hr test periods in air at 20 C (dry control, DC); water at 34.5 C (wet control, WC); and water (34.5 C) after hemorrhage (WH) of 14.8 plus or minus 0.3 percent of their blood volume. Blood volume was -11.6 plus or minus 0.6 percent at immersion (time 0). Mean (bar-X hrs 1-5) Q(sub co) was unchanged in WC (5.3 plus or minus 0.01 l/min) and in WH (4.5 plus or minus 0.1 l/min), but decreased (P less than 0.05) in DC to 3.6 plus or minus 0.1 l/min. Mean urine excretion rates were 1.0 plus or minus 0.2 ml/min for DC and 1.1 plus or minus 0.2 ml/min for WH; both were lower (P less than 0.05) than that for WC of 2.0 plus or minus 0.4 ml/min. Plasma (Na+) and (Osm) were unchanged in all experiments. Mean plasma vasopressin (PVP) (bar-X hrs 1-5) was 1.1 plus or minus 0.1 pg/ml in WC, and higher (P less than 0.05) in DC (2.1 plus or minus 0.2 pg/ml)and WH (2.1 plus or minus 0.1 pg/ml); it was unchanged during air and water test periods. Thus, hemorrhage attenuated the immersion-induced increase in Q(sub co), eliminated the WC diuresis, maintained plasma renin activity and PVP at DC levels and did not change immersion-induced aldosterone suppression; the osmotic diuresis during control immersion is apparently not due to either aldosterone suppression or vasopressin suppression.

  4. Cardiac Output Monitoring Managing Intravenous Therapy (COMMIT) to Treat Emergency Department Patients with Sepsis

    PubMed Central

    Hou, Peter C.; Filbin, Michael R.; Napoli, Anthony; Feldman, Joseph; Pang, Peter S.; Sankoff, Jeffrey; Lo, Bruce M.; Dickey-White, Howard; Birkhahn, Robert H.; Shapiro, Nathan I.

    2016-01-01

    ABSTRACT Objective: Fluid responsiveness is proposed as a physiology-based method to titrate fluid therapy based on preload dependence. The objectives of this study were to determine if a fluid responsiveness protocol would decrease progression of organ dysfunction, and a fluid responsiveness protocol would facilitate a more aggressive resuscitation. Methods: Prospective, 10-center, randomized interventional trial. Inclusion criteria: suspected sepsis and lactate 2.0 to 4.0 mmol/L. Exclusion criteria (abbreviated): systolic blood pressure more than 90 mmHg, and contraindication to aggressive fluid resuscitation. Intervention: fluid responsiveness protocol using Non-Invasive Cardiac Output Monitor (NICOM) to assess for fluid responsiveness (>10% increase in stroke volume in response to 5 mL/kg fluid bolus) with balance of a liter given in responsive patients. Control: standard clinical care. Outcomes: primary—change in Sepsis-related Organ Failure Assessment (SOFA) score at least 1 over 72 h; secondary—fluids administered. Trial was initially powered at 600 patients, but stopped early due to a change in sponsor's funding priorities. Results: Sixty-four patients were enrolled with 32 in the treatment arm. There were no significant differences between arms in age, comorbidities, baseline vital signs, or SOFA scores (P > 0.05 for all). Comparing treatment versus Standard of Care—there was no difference in proportion of increase in SOFA score of at least 1 point (30% vs. 33%) (note bene underpowered, P = 1.0) or mean preprotocol fluids 1,050 mL (95% confidence interval [CI]: 786–1,314) vs. 1,031 mL (95% CI: 741–1,325) (P = 0.93); however, treatment patients received more fluids during the protocol (2,633 mL [95% CI: 2,264–3,001] vs. 1,002 mL [95% CI: 707–1,298]) (P < 0.001). Conclusions: In this study of a “preshock” population, there was no change in progression of organ dysfunction with a fluid responsiveness protocol

  5. Cardiac output by Doppler echocardiography in the premature baboon: Comparison with radiolabeled microspheres

    SciTech Connect

    Kinsella, J.P.; Morrow, W.R.; Gerstmann, D.R.; Taylor, A.F.; deLemos, R.A. )

    1991-04-01

    Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDE LVO was 152 ml/min/kg (range, 40-258 ml/min/kg) compared to 158 ml/min/kg (range, 67-278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (gamma = 0.94x + 4.20, r = 0.91, SEE = 25.7 ml). The authors conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress.

  6. Measurement of the total acoustic output power of HITU transducers

    NASA Astrophysics Data System (ADS)

    Jenderka, Klaus-V.; Beissner, Klaus

    2010-03-01

    The majority of High Intensity Therapeutic Ultrasound (HITU) applications use strongly focused ultrasound fields generating very high local intensities in the focal region. The metrology of these high-power ultrasound fields is a challenge for the established measurement procedures and devices. This paper describes the results of measurements by means of the radiation force for a total acoustic output power up to 400 W at 1.5 MHz and up to 200 W at 2.45 MHz. For this purpose, a radiation force balance set-up was adapted for the determination of large acoustic output powers. For two types of HITU transducers, the relationship between the total acoustic output power and the applied net electrical power was determined at close transducer-target distance. Further, dependence of the measured electro-acoustic radiation conductance on the transducer-target distance was investigated at reduced power levels, considering the appearance of focal anomalies. Concluding, a list of the main uncertainty contributions, and an estimate of the uncertainty for the used radiation force balance set-up is given for measurements at high power levels.

  7. Measuring fluid flow and heat output in seafloor hydrothermal environments

    NASA Astrophysics Data System (ADS)

    Germanovich, Leonid N.; Hurt, Robert S.; Smith, Joshua E.; Genc, Gence; Lowell, Robert P.

    2015-12-01

    We review techniques for measuring fluid flow and advective heat output from seafloor hydrothermal systems and describe new anemometer and turbine flowmeter devices we have designed, built, calibrated, and tested. These devices allow measuring fluid velocity at high- and low-temperature focused and diffuse discharge sites at oceanic spreading centers. The devices perform at ocean floor depths and black smoker temperatures and can be used to measure flow rates ranging over 2 orders of magnitude. Flow velocity is determined from the rotation rate of the rotor blades or paddle assembly. These devices have an open bearing design that eliminates clogging by particles or chemical precipitates as the fluid passes by the rotors. The devices are compact and lightweight enough for deployment from either an occupied or remotely operated submersible. The measured flow rates can be used in conjunction with vent temperature or geochemical measurements to obtain heat outputs or geochemical fluxes from both vent chimneys and diffuse flow regions. The devices have been tested on 30 Alvin dives on the Juan de Fuca Ridge and 3 Jason dives on the East Pacific Rise (EPR). We measured an anomalously low entrainment coefficient (0.064) and report 104 new measurements over a wide range of discharge temperatures (5°-363°C), velocities (2-199 cm/s), and depths (1517-2511 m). These include the first advective heat output measurements at the High Rise vent field and the first direct fluid flow measurement at Middle Valley. Our data suggest that black smoker heat output at the Main Endeavour vent field may have declined since 1994 and that after the 2005-2006 eruption, the high-temperature advective flow at the EPR 9°50'N field may have become more channelized, predominately discharging through the Bio 9 structure. We also report 16 measurements on 10 Alvin dives and 2 Jason dives with flow meters that predate devices described in this work and were used in the process of their development

  8. Comparison of Maximum Vasoactive Inotropic Score and Low Cardiac Output Syndrome As Markers of Early Postoperative Outcomes After Neonatal Cardiac Surgery

    PubMed Central

    Butts, Ryan J.; Scheurer, Mark A.; Atz, Andrew M.; Zyblewski, Sinai C.; Hulsey, Thomas C.; Bradley, Scott M.; Graham, Eric M.

    2014-01-01

    Low cardiac output syndrome (LCOS) and maximum vasoactive inotropic score (VIS) have been used as surrogate markers for early postoperative outcomes in pediatric cardiac surgery. The objective of this study was to determine the associations between LCOS and maximum VIS with clinical outcomes in neonatal cardiac surgery. This was a secondary retrospective analysis of a prospective randomized trial, and the setting was a pediatric cardiac intensive care unit in a tertiary care children's hospital. Neonates (n = 76) undergoing corrective or palliative cardiac operations requiring cardiopulmonary bypass were prospectively enrolled. LCOS was defined by a standardized clinical criteria. VIS values were calculated by a standard formula during the first 36 postoperative hours, and the maximum score was recorded. Postoperative outcomes included hospital mortality, duration of mechanical ventilation, intensive care unit (ICU) and hospital lengths of stay (LOS), as well as total hospital charges. At surgery, the median age was 7 days and weight was 3.2 kg. LCOS occurred in 32 of 76 (42%) subjects. Median maximum VIS was 15 (range 5–33). LCOS was not associated with duration of mechanical ventilation, ICU LOS, hospital LOS, and hospital charges. Greater VIS was moderately associated with a longer duration of mechanical ventilation (p = 0.001, r = 0.36), longer ICU LOS (p = 0.02, r = 0.27), and greater total hospital costs (p = 0.05, r = 0.22) but not hospital LOS (p = 0.52). LCOS was not associated with early postoperative outcomes. Maximum VIS has only modest correlation with duration of mechanical ventilation, ICU LOS, and total hospital charges. PMID:22349666

  9. Measuring quality of life in cardiac spouses.

    PubMed

    Ebbesen, L S; Guyatt, G H; McCartney, N; Oldridge, N B

    1990-01-01

    The purpose of this study was to develop an objective instrument to measure changes in quality of life of spouses of post-myocardial infarction (MI) patients, and to determine its responsiveness and validity. A 70-item list of potential areas of concern was compiled; the 25 most frequent and important concerns comprised the framework of the final questionnaire. The questions on the Quality of Life Questionnaire for Cardiac Spouses (QL-SP) were categorized into the Emotional Function Dimension (EFD), and the Physical and Social Function Dimension (PSFD). Subjects (n = 39) completed the QL-SP and a battery of established questionnaires at home, 1-2 weeks post-hospital discharge for the patient, and 8 weeks later. Scores on the QL-SP between visits were improved for both the EFD (t = 5.56, p less than 0.001), and the PSFD (t = 6.11, p less than 0.001). The agreement between predicted and observed relationships between the dimension changes and other index changes, as measured statistically by a kappa with Cicchetti weights, was significant (kappa w = 0.43, p = 0.0012). The QL-SP appears to be responsive and valid, and may be useful in evaluating clinical and research intervention strategies. PMID:2324789

  10. GLUCAGON LIKE PEPTIDE-1(7–36) BUT NOT (9–36) AUGMENTS CARDIAC OUTPUT DURING MYOCARDIAL ISCHEMIA VIA AFRANK-STARLING MECHANISM

    PubMed Central

    Goodwill, Adam G.; Tune, Johnathan D.; Noblet, Jillian N.; Conteh, Abass M.; Sassoon, Daniel; Casalini, Eli D.; Mather, Kieren J.

    2014-01-01

    This study examined the cardiovascular effects of GLP-1 (7–36) or (9–36) on myocardial oxygen consumption, function and systemic hemodynamics in vivo during normal perfusion and during acute, regional myocardial ischemia. Lean Ossabaw swine received systemic infusions of saline vehicle or GLP-1 (7–36 or 9–36) at 1.5, 3.0, and 10.0 pmol/kg/min in sequence for 30 min at each dose, followed by ligation of the left circumflex artery during continued infusion at 10.0 pmol/kg/min. Systemic GLP-1 (9–36) had no effect on coronary flow, blood pressure, heart rate or indices of cardiac function before or during regional myocardial ischemia. Systemic GLP-1 (7–36) exerted no cardiometabolic or hemodynamic effects prior to ischemia. During ischemia, GLP-1 (7–36) increased cardiac output by approximately 2 L/min relative to vehicle-controls (p=0.003). This response was not diminished by treatment with the non-depolarizing ganglionic blocker hexamethonium. Left ventricular pressure-volume loops measured during steady state conditions with graded occlusion of the inferior vena cava to assess load-independent contractility revealed that GLP-1 (7–36) produced marked increases in end diastolic volume (74 ± 1 to 92 ± 5 mL; p=0.03) and volume axis intercept (8 ± 2 to 26 ± 8; p=0.05), without any change in the slope of the end systolic pressure volume relationship vs. vehicle during regional ischemia. GLP-1 (9–36) produced no changes in any of these parameters compared to vehicle. These findings indicate that short-term systemic treatment with GLP-1 (7–36) but not GLP-1 (9–36) significantly augments cardiac output during regional myocardial ischemia, via increases in ventricular preload without changes in cardiac inotropy. PMID:25005062

  11. [A new parameter measurement system for electrosurgery output].

    PubMed

    Zhou, Yu; Li, Dianli; Xu, Wendong; Song, Chengli

    2014-04-01

    Accurate measurements of voltage and current from electrosurgery are the basis of development of electrosurgery with feedback function. We, therefore, developed a parameter measurement system based on PC, with high voltage and current from electrosurgery being sensed with transformers, amplified, filtered, transformed into single-ended signals, and then into RMS signals. The root mean square (RMS) signals were transformed into digital signals through DAQ card and the data was processed in PC with Labview. The process included sampling, displaying and storage. The experiment results indicated that the measurement system could measure the output parameters from electrosurgery steadily and correctly so that the development of the system has been successful. It can be the basis of development of embedded parameters measurement system and can provide accurate feedback information for intellectual electrosurgery. PMID:25039153

  12. The thick left ventricular wall of the giraffe heart normalises wall tension, but limits stroke volume and cardiac output.

    PubMed

    Smerup, Morten; Damkjær, Mads; Brøndum, Emil; Baandrup, Ulrik T; Kristiansen, Steen Buus; Nygaard, Hans; Funder, Jonas; Aalkjær, Christian; Sauer, Cathrine; Buchanan, Rasmus; Bertelsen, Mads Frost; Østergaard, Kristine; Grøndahl, Carsten; Candy, Geoffrey; Hasenkam, J Michael; Secher, Niels H; Bie, Peter; Wang, Tobias

    2016-02-01

    Giraffes--the tallest extant animals on Earth--are renowned for their high central arterial blood pressure, which is necessary to secure brain perfusion. Arterial pressure may exceed 300 mmHg and has historically been attributed to an exceptionally large heart. Recently, this has been refuted by several studies demonstrating that the mass of giraffe heart is similar to that of other mammals when expressed relative to body mass. It thus remains unexplained how the normal-sized giraffe heart generates such massive arterial pressures. We hypothesized that giraffe hearts have a small intraventricular cavity and a relatively thick ventricular wall, allowing for generation of high arterial pressures at normal left ventricular wall tension. In nine anaesthetized giraffes (495±38 kg), we determined in vivo ventricular dimensions using echocardiography along with intraventricular and aortic pressures to calculate left ventricular wall stress. Cardiac output was also determined by inert gas rebreathing to provide an additional and independent estimate of stroke volume. Echocardiography and inert gas-rebreathing yielded similar cardiac outputs of 16.1±2.5 and 16.4±1.4 l min(-1), respectively. End-diastolic and end-systolic volumes were 521±61 ml and 228±42 ml, respectively, yielding an ejection fraction of 56±4% and a stroke volume of 0.59 ml kg(-1). Left ventricular circumferential wall stress was 7.83±1.76 kPa. We conclude that, relative to body mass, a small left ventricular cavity and a low stroke volume characterizes the giraffe heart. The adaptations result in typical mammalian left ventricular wall tensions, but produce a lowered cardiac output. PMID:26643090

  13. Alteration in systemic vascular resistance and cardiac output during acute cellular rejection and recovery in heart transplant recipients.

    PubMed

    Garan, Arthur R; Uriel, Nir; Sayer, Gabriel; Sims, Daniel; Zahner, Doris; Farr, Maryjane; Mancini, Donna; Jorde, Ulrich P

    2010-03-01

    Coronary vascular reserve is impaired during acute cellular rejection of the orthotopically transplanted heart, but changes in the peripheral vasculature during rejection have not been well described. To investigate whether peripheral vascular compensatory mechanisms are preserved after orthotopic heart transplantation (OHT), we longitudinally observed systemic vascular resistance (SVR) and cardiac output (CO) during acute cellular rejection. CO decreased during high-grade acute cellular rejection, and maintenance of mean arterial pressure was achieved by increases in SVR, and these changes did not return to baseline until several months after histologic resolution of rejection. PMID:19875310

  14. The effect of changes in cardiac output on middle cerebral artery mean blood velocity at rest and during exercise

    PubMed Central

    Ogoh, Shigehiko; Brothers, R Matthew; Barnes, Quinton; Eubank, Wendy L; Hawkins, Megan N; Purkayastha, Sushmita; O-Yurvati, Albert; Raven, Peter B

    2005-01-01

    We examined the relationship between changes in cardiac output and middle cerebral artery mean blood velocity (MCA Vmean) in seven healthy volunteer men at rest and during 50% maximal oxygen uptake steady-state submaximal cycling exercise. Reductions in were accomplished using lower body negative pressure (LBNP), while increases in were accomplished using infusions of 25% human serum albumin. Heart rate (HR), arterial blood pressure and MCA Vmean were continuously recorded. At each stage of LBNP and albumin infusion was measured using an acetylene rebreathing technique. Arterial blood samples were analysed for partial pressure of carbon dioxide tension (Pa,CO2. During exercise HR and were increased above rest (P < 0.001), while neither MCA Vmean nor Pa,CO2 was altered (P > 0.05). The MCA Vmean and were linearly related at rest (P < 0.001) and during exercise (P = 0.035). The slope of the regression relationship between MCA Vmean and at rest was greater (P = 0.035) than during exercise. In addition, the phase and gain between MCA Vmean and mean arterial pressure in the low frequency range were not altered from rest to exercise indicating that the cerebral autoregulation was maintained. These data suggest that the associated with the changes in central blood volume influence the MCA Vmean at rest and during exercise and its regulation is independent of cerebral autoregulation. It appears that the exercise induced sympathoexcitation and the change in the distribution of between the cerebral and the systemic circulation modifies the relationship between MCA Vmean and . PMID:16210355

  15. The effects on increasing cardiac output with adrenaline or isoprenaline on arterial haemoglobin oxygen saturation and shunt during one-lung ventilation.

    PubMed

    Russell, W J; James, M F

    2000-12-01

    Theoretically, if the cardiac output were increased in the presence of a given intrapulmonary shunt, the arterial haemoglobin oxygen saturation (SaO2) should improve as the venous oxygen extraction per ml of blood decreases. To test this hypothesis, eight pigs were subjected to one-lung ventilation and adrenaline and isoprenaline infusions used to increase the cardiac output. The mixed venous oxygen, shunt fraction and oxygen consumption were measured. With both adrenaline and isoprenaline, although there was a small rise in mixed venous oxygen content, there was a fall in SaO2. With adrenaline, the mean shunt rose from 48% to 65%, the mean oxygen consumption rose from 126 ml/min to 134 ml/min and the mean SaO2 fell from 86.9% to 82.5%. With isoprenaline, the mean shunt rose from 45% to 59%, the mean oxygen consumption rose from 121 ml/min to 137 ml/min and the mean SaO2 fell from 89.5% to 84.7%. It is concluded that potential improvement in SaO2, which might occur from a catecholamine-induced increase in mixed venous oxygen content during one-lung ventilation, is more than offset by increased shunting and oxygen consumption which reduce SaO2. PMID:11153288

  16. Blood-Pressure Measuring System Gives Accurate Graphic Output

    NASA Technical Reports Server (NTRS)

    1965-01-01

    The problem: To develop an instrument that will provide an external (indirect) measurement of arterial blood pressure in the form of an easily interpreted graphic trace that can be correlated with standard clinical blood-pressure measurements. From sphygmograms produced by conventional sphygmographs, it is very difficult to differentiate the systolic and diastolic blood-pressure pulses and to correlate these indices with the standard clinical values. It is nearly impossible to determine these indices when the subject is under physical or emotional stress. The solution: An electronic blood-pressure system, basically similar to conventional ausculatory sphygmomanometers, employing a standard occluding cuff, a gas-pressure source, and a gas-pressure regulator and valve. An electrical output transducer senses cuff pressure, and a microphone positioned on the brachial artery under the occluding cuff monitors the Korotkoff sounds from this artery. The output signals present the conventional systolic and diastolic indices in a clear, graphical display. The complete system also includes an electronic timer and cycle-control circuit.

  17. Evaluating cardiac physiology through echocardiography in bottlenose dolphins: using stroke volume and cardiac output to estimate systolic left ventricular function during rest and following exercise.

    PubMed

    Miedler, Stefan; Fahlman, Andreas; Valls Torres, Mónica; Álvaro Álvarez, Teresa; Garcia-Parraga, Daniel

    2015-11-01

    Heart-rate (fH) changes during diving and exercise are well documented for marine mammals, but changes in stroke volume (SV) and cardiac output (CO) are much less known. We hypothesized that both SV and CO are also modified following intense exercise. Using transthoracic ultrasound Doppler at the level of the aortic valve, we compared blood flow velocities in the left ventricle and cardiac frequencies during rest and at 1, 3 and 4 min after a bout of exercise in 13 adult bottlenose dolphins (Tursiops truncatus, six male and seven female, body mass range 143-212 kg). Aortic cross-sectional area and ventricle blood velocity at the aortic valve were used to calculate SV, which together with fH provided estimates of left CO at rest and following exercise. fH and SV stabilized approximately 4-7 s following the post-respiratory tachycardia, so only data after the fH had stabilized were used for analysis and comparison. There were significant increases in fH, SV and CO associated with each breath. At rest, fH, SV and CO were uncorrelated with body mass, and averaged 41±9 beats min(-1), 136±19 ml and 5514±1182 l min(-1), respectively. One minute following high intensity exercise, the cardiac variables had increased by 104±43%, 63±11% and 234±84%, respectively. All variables remained significantly elevated in all animals for at least 4 min after the exercise. These baseline values provide the first data on SV and CO in awake and unrestrained cetaceans in water. PMID:26385334

  18. [RESUSCITATION MEASURES IN CASE OF CARDIAC ARREST].

    PubMed

    Lamhaut, Lionel; Cariou, Alain

    2015-09-01

    Improving the survival rate of sudden cardiac death victims mainly relies in the prompt activation of the "chain of survival", resulting in efficient performance at basic life support maneuvers by bystanders. Among these maneuvers, cardiac compressions and use of automated external defibrillation are the most important components. Since basic life support is easy to learn, spreading its practice throughout the general population should be a priority for public health policy. Following initial resuscitation, the last step of the "chain of survival" is ensured by expert pre-hospital and ICU teams, which are able to provide appropriate care. Organization and sequence of these different steps are the object of regularly updated guidelines, summarized in the form of algorithms that facilitate their application. PMID:26619726

  19. Optimal dose of landiolol for preventing abrupt changes in both cardiac output and middle cerebral artery flow velocity after electroconvulsive therapy.

    PubMed

    Kadoi, Yuji; Saito, Shigeru

    2014-09-01

    The purpose of this study was to examine the dose-dependent effects of landiolol on systemic hemodynamics, cardiac output, and cerebral artery blood flow. Eight patients undergoing electroconvulsive therapy (ECT) received 1 of the 3 drugs/doses (saline, 0.125 mg/kg of landiolol, 0.25 mg/kg of landiolol), in turn, for 3 ECT sessions, immediately after the administration of succinylcholine. In the case of 0.25 mg/kg of landiolol, heart rate, mean arterial pressure, and cardiac output remained unchanged throughout the study period.We believe that 0.25 mg/kg of landiolol may be suitable for preventing the increase in systemic hemodynamics, including cardiac output after ECT. PMID:24755725

  20. The effect of intravenous epoprostenol (prostacyclin, PGI2) on cerebral blood flow and cardiac output in man.

    PubMed Central

    Cook, P J; Maidment, C G; Dandona, P; Hutton, R A; James, I M

    1983-01-01

    Epoprostenol (prostacyclin, PGI2) was given intravenously to seven healthy volunteers in a dose of 4 ng kg-1 min-1 over a 30 min period. Diastolic blood pressure fell but there was no change in cardiac output. The mean PGI2 concentration at the end of the infusion was 0.43 ng/ml (1.1 nM) and a significant inhibition of ADP-induced platelet aggregation occurred. Although obvious facial flushing occurred in all subjects and some subjects complained of headache, cerebral blood flow tended to fall. The results do not support the hypothesis that PGI2 acts as a physiological vasodilator involved in the homeostasis of normal cerebral blood flow. PMID:6362696

  1. Continuous cardiac output and left atrial pressure monitoring by long time interval analysis of the pulmonary artery pressure waveform: proof of concept in dogs.

    PubMed

    Xu, Da; Olivier, N Bari; Mukkamala, Ramakrishna

    2009-02-01

    We developed a technique to continuously (i.e., automatically) monitor cardiac output (CO) and left atrial pressure (LAP) by mathematical analysis of the pulmonary artery pressure (PAP) waveform. The technique is unique to the few previous related techniques in that it jointly estimates the two hemodynamic variables and analyzes the PAP waveform over time scales greater than a cardiac cycle wherein wave reflections and inertial effects cease to be major factors. First, a 6-min PAP waveform segment is analyzed so as to determine the pure exponential decay and equilibrium pressure that would eventually result if cardiac activity suddenly ceased (i.e., after the confounding wave reflections and inertial effects vanish). Then, the time constant of this exponential decay is computed and assumed to be proportional to the average pulmonary arterial resistance according to a Windkessel model, while the equilibrium pressure is regarded as average LAP. Finally, average proportional CO is determined similar to invoking Ohm's law and readily calibrated with one thermodilution measurement. To evaluate the technique, we performed experiments in five dogs in which the PAP waveform and accurate, but highly invasive, aortic flow probe CO and LAP catheter measurements were simultaneously recorded during common hemodynamic interventions. Our results showed overall calibrated CO and absolute LAP root-mean-squared errors of 15.2% and 1.7 mmHg, respectively. For comparison, the root-mean-squared error of classic end-diastolic PAP estimates of LAP was 4.7 mmHg. On future successful human testing, the technique may potentially be employed for continuous hemodynamic monitoring in critically ill patients with pulmonary artery catheters. PMID:19057003

  2. A sensitive flow-through microcalorimeter for measuring the heat production of cardiac trabeculae.

    PubMed

    Taberner, A; Kirton, R; F Nielsen, P; Loiselle, D; Hunter, I

    2004-01-01

    Measurement of the energy consumption of isolated cardiac muscle requires a flow-through microcalorimeter with sensitivity in the microW range. In this paper we describe and characterize a sensitive flow-through microcalorimeter, designed and constructed for measuring the heat output of cardiac trabeculae. The device exploits a non-contact, temperature-sensing technique utilizing infra-red-sensitive, thin-film thermopile sensors. The microcalorimeter achieves a sensitivity of 1.8-1.9 V/W at a flow rate of 1 microl/s, with a time constant of approximately 3.5 s. The typical power signal-to-noise ratio is better than 200. Predictions of a finite element model of the calorimeter's characteristics compare favourably with measured data. PMID:17272117

  3. Nine Criteria for a Measure of Scientific Output

    PubMed Central

    Kreiman, Gabriel; Maunsell, John H. R.

    2011-01-01

    Scientific research produces new knowledge, technologies, and clinical treatments that can lead to enormous returns. Often, the path from basic research to new paradigms and direct impact on society takes time. Precise quantification of scientific output in the short-term is not an easy task but is critical for evaluating scientists, laboratories, departments, and institutions. While there have been attempts to quantifying scientific output, we argue that current methods are not ideal and suffer from solvable difficulties. Here we propose criteria that a metric should have to be considered a good index of scientific output. Specifically, we argue that such an index should be quantitative, based on robust data, rapidly updated and retrospective, presented with confidence intervals, normalized by number of contributors, career stage and discipline, impractical to manipulate, and focused on quality over quantity. Such an index should be validated through empirical testing. The purpose of quantitatively evaluating scientific output is not to replace careful, rigorous review by experts but rather to complement those efforts. Because it has the potential to greatly influence the efficiency of scientific research, we have a duty to reflect upon and implement novel and rigorous ways of evaluating scientific output. The criteria proposed here provide initial steps toward the systematic development and validation of a metric to evaluate scientific output. PMID:22102840

  4. Measuring mitochondrial function in intact cardiac myocytes

    PubMed Central

    Dedkova, Elena N.; Blatter, Lothar A.

    2011-01-01

    Mitochondria are involved in cellular functions that go beyond the traditional role of these organelles as the power plants of the cell. Mitochondria have been implicated in several human diseases, including cardiac dysfunction, and play a role in the aging process. Many aspects of our knowledge of mitochondria stem from studies performed on the isolated organelle. Their relative inaccessibility imposes experimental difficulties to study mitochondria in their natural environment – the cytosol of intact cells – and has hampered a comprehensive understanding of the plethora of mitochondrial functions. Here we review currently available methods to study mitochondrial function in intact cardiomyocytes. These methods primarily use different flavors of fluorescent dyes and genetically encoded fluorescent proteins in conjunction with high-resolution imaging techniques. We review methods to study mitochondrial morphology, mitochondrial membrane potential, Ca2+ and Na+ signaling, mitochondrial pH regulation, redox state and ROS production, NO signaling, oxygen consumption, ATP generation and the activity of the mitochondrial permeability transition pore. Where appropriate we complement this review on intact myocytes with seminal studies that were performed on isolated mitochondria, permeabilized cells, and in whole hearts. PMID:21964191

  5. Role of cardiac output and the autonomic nervous system in the antinatriuretic response to acute constriction of the thoracic superior vena cava.

    NASA Technical Reports Server (NTRS)

    Schrier, R. W.; Humphreys, M. H.; Ufferman, R. C.

    1971-01-01

    Study of the differential characteristics of hepatic congestion and decreased cardiac output in terms of potential afferent stimuli in the antinatriuretic effect of acute thoracic inferior vena cava (TIVC) constriction. An attempt is made to see if the autonomic nervous system is involved in the antinatriuretic effect of acute TIVC or thoracic superior vena cava constriction.

  6. Output trends, characteristics, and measurements of three megavoltage radiotherapy linear accelerators.

    PubMed

    Hossain, Murshed

    2014-01-01

    The purpose of this study is to characterize and understand the long-term behavior of the output from megavoltage radiotherapy linear accelerators. Output trends of nine beams from three linear accelerators over a period of more than three years are reported and analyzed. Output, taken during daily warm-up, forms the basis of this study. The output is measured using devices having ion chambers. These are not calibrated by accredited dosimetry laboratory, but are baseline-compared against monthly output which is measured using calibrated ion chambers. We consider the output from the daily check devices as it is, and sometimes normalized it by the actual output measured during the monthly calibration of the linacs. The data show noisy quasi-periodic behavior. The output variation, if normalized by monthly measured "real' output, is bounded between ± 3%. Beams of different energies from the same linac are correlated with a correlation coefficient as high as 0.97, for one particular linac, and as low as 0.44 for another. These maximum and minimum correlations drop to 0.78 and 0.25 when daily output is normalized by the monthly measurements. These results suggest that the origin of these correlations is both the linacs and the daily output check devices. Beams from different linacs, independent of their energies, have lower correlation coefficient, with a maximum of about 0.50 and a minimum of almost zero. The maximum correlation drops to almost zero if the output is normalized by the monthly measured output. Some scatter plots of pairs of beam output from the same linac show band-like structures. These structures are blurred when the output is normalized by the monthly calibrated output. Fourier decomposition of the quasi-periodic output is consistent with a 1/f power law. The output variation appears to come from a distorted normal distribution with a mean of slightly greater than unity. The quasi-periodic behavior is manifested in the seasonally averaged output

  7. Output trends, characteristics, and measurements of three mega-voltage radiotherapy linear accelerators

    PubMed Central

    Hossain, Murshed

    2015-01-01

    The purpose of this study is to characterize and understand the long term behavior of the output from megavoltage radiotherapy linear accelerators. Output trends of nine beams from three linear accelerators over a period of more than three years are reported and analyzed. Output taken during daily warm-up forms the basis of this study. The output is measured using devices having ion-chambers. These are not calibrated by accredited dosimetry laboratory but are baseline compared against monthly output which are measured using calibrated ion-chambers. We consider the output from the daily check devices as it is and sometimes normalized them by the actual output measured during the monthly calibration of the Linacs. The data shows noisy quasi-periodic behavior. The output variation if normalized by monthly measured “real’ output, is bounded between ±3%. Beams of different energies from the same Linac are correlated with a correlation coefficient as high as 0.97 for one particular Linac and as low as 0.44 for another. These maximum and minimum correlations drop to 0.78 and 0.25 when daily output is normalized by the monthly measurements. These results suggest that the origin of these correlations are both the Linacs and the daily output check devices. Beams from different Linacs, independent of their energies, have lower correlation coefficient with a maximum of about 0.50 and a minimum of almost zero. The maximum correlation drops to almost zero if the output is normalized by the monthly measured output. Some scatter plots of pairs of beam-output from the same Linac show band-like structures. These structures are blurred when the output is normalized by the monthly calibrated output. Fourier decomposition of the quasi periodic output is consistent with a 1/f power law. The output variation appears to come from a distorted normal distribution with a mean of slightly greater than unity. The quasi-periodic behavior is manifested in the seasonally averaged output

  8. Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity.

    PubMed

    Verbanck, S; Larsson, H; Linnarsson, D; Prisk, G K; West, J B; Paiva, M

    1997-09-01

    In microgravity (microG) humans have marked changes in body fluids, with a combination of an overall fluid loss and a redistribution of fluids in the cranial direction. We investigated whether interstitial pulmonary edema develops as a result of a headward fluid shift or whether pulmonary tissue fluid volume is reduced as a result of the overall loss of body fluid. We measured pulmonary tissue volume (Vti), capillary blood flow, and diffusing capacity in four subjects before, during, and after 10 days of exposure to microG during spaceflight. Measurements were made by rebreathing a gas mixture containing small amounts of acetylene, carbon monoxide, and argon. Measurements made early in flight in two subjects showed no change in Vti despite large increases in stroke volume (40%) and diffusing capacity (13%) consistent with increased pulmonary capillary blood volume. Late in-flight measurements in four subjects showed a 25% reduction in Vti compared with preflight controls (P < 0.001). There was a concomittant reduction in stroke volume, to the extent that it was no longer significantly different from preflight control. Diffusing capacity remained elevated (11%; P < 0.05) late in flight. These findings suggest that, despite increased pulmonary perfusion and pulmonary capillary blood volume, interstitial pulmonary edema does not result from exposure to microG. PMID:9292467

  9. Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity

    NASA Technical Reports Server (NTRS)

    Verbanck, S.; Larsson, H.; Linnarsson, D.; Prisk, G. K.; West, J. B.; Paiva, M.

    1997-01-01

    In microgravity (microG) humans have marked changes in body fluids, with a combination of an overall fluid loss and a redistribution of fluids in the cranial direction. We investigated whether interstitial pulmonary edema develops as a result of a headward fluid shift or whether pulmonary tissue fluid volume is reduced as a result of the overall loss of body fluid. We measured pulmonary tissue volume (Vti), capillary blood flow, and diffusing capacity in four subjects before, during, and after 10 days of exposure to microG during spaceflight. Measurements were made by rebreathing a gas mixture containing small amounts of acetylene, carbon monoxide, and argon. Measurements made early in flight in two subjects showed no change in Vti despite large increases in stroke volume (40%) and diffusing capacity (13%) consistent with increased pulmonary capillary blood volume. Late in-flight measurements in four subjects showed a 25% reduction in Vti compared with preflight controls (P < 0.001). There was a concomittant reduction in stroke volume, to the extent that it was no longer significantly different from preflight control. Diffusing capacity remained elevated (11%; P < 0.05) late in flight. These findings suggest that, despite increased pulmonary perfusion and pulmonary capillary blood volume, interstitial pulmonary edema does not result from exposure to microG.

  10. Measuring Equity: Creating a New Standard for Inputs and Outputs

    ERIC Educational Resources Information Center

    Knoeppel, Robert C.; Della Sala, Matthew R.

    2013-01-01

    The purpose of this article is to introduce a new statistic to capture the ratio of equitable student outcomes given equitable inputs. Given the fact that finance structures should be aligned to outcome standards according to judicial interpretation, a ratio of outputs to inputs, or "equity ratio," is introduced to discern if conclusions can be…

  11. Diesel Exhaust Inhalation Increases Cardiac Output, Bradyarrhythmias, and Parasympathetic Tone in Aged Heart Failure-Prone Rats

    EPA Science Inventory

    Acute air pollutant inhalation is linked to adverse cardiac events and death, and hospitalizations for heart failure. Diesel exhaust (DE) is a major air pollutant suspected to exacerbate preexisting cardiac conditions, in part, through autonomic and electrophysiologic disturbance...

  12. Methodology of method comparison studies evaluating the validity of cardiac output monitors: a stepwise approach and checklist.

    PubMed

    Montenij, L J; Buhre, W F; Jansen, J R; Kruitwagen, C L; de Waal, E E

    2016-06-01

    The validity of each new cardiac output (CO) monitor should be established before implementation in clinical practice. For this purpose, method comparison studies investigate the accuracy and precision against a reference technique. With the emergence of continuous CO monitors, the ability to detect changes in CO, in addition to its absolute value, has gained interest. Therefore, method comparison studies increasingly include assessment of trending ability in the data analysis. A number of methodological challenges arise in method comparison research with respect to the application of Bland-Altman and trending analysis. Failure to face these methodological challenges will lead to misinterpretation and erroneous conclusions. We therefore review the basic principles and pitfalls of Bland-Altman analysis in method comparison studies concerning new CO monitors. In addition, the concept of clinical concordance is introduced to evaluate trending ability from a clinical perspective. The primary scope of this review is to provide a complete overview of the pitfalls in CO method comparison research, whereas other publications focused on a single aspect of the study design or data analysis. This leads to a stepwise approach and checklist for a complete data analysis and data representation. PMID:27199309

  13. Comparing the accuracy of ES-BC, EIS-GS, and ES Oxi on body composition, autonomic nervous system activity, and cardiac output to standardized assessments

    PubMed Central

    Lewis, John E; Tannenbaum, Stacey L; Gao, Jinrun; Melillo, Angelica B; Long, Evan G; Alonso, Yaima; Konefal, Janet; Woolger, Judi M; Leonard, Susanna; Singh, Prabjot K; Chen, Lawrence; Tiozzo, Eduard

    2011-01-01

    Background and purpose The Electro Sensor Complex (ESC) is software that combines three devices using bioelectrical impedance, galvanic skin response, and spectrophotometry: (1) ES-BC (Electro Sensor-Body Composition; LD Technology, Miami, FL) to assess body composition, (2) EIS-GS (Electro Interstitial Scan-Galvanic Skin; LD Technology) to predict autonomic nervous system activity, and (3) ES Oxi (Electro Sensor Oxi; LD Technology) to assess cardiac output. The objective of this study was to compare each to a standardized assessment: ES-BC to dual-energy X-ray absorptiometry (DXA), EIS-GS to heart rate variability, and ES Oxi to BioZ Dx Diagnostic System (BioZ Dx; SonoSite Inc, Bothell, WA). Patients and methods The study was conducted in two waves. Fifty subjects were assessed for body composition and autonomic nervous system activity. Fifty-one subjects were assessed for cardiac output. Results We found adequate relative and absolute agreement between ES-BC and DXA for fat mass (r = 0.97, P < 0.001) with ES-BC overestimating fat mass by 0.1 kg and for body fat percentage (r = 0.92, P < 0.001) with overestimation of fat percentage by 0.4%. For autonomic nervous system activity, we found marginal relative agreement between EIS-GS and heart rate variability by using EIS-GS as the predictor in a linear regression equation (adjusted R2 = 0.56, P = 0.03). For cardiac output, adequate relative and absolute agreement was found between ES Oxi and BioZ Dx at baseline (r = 0.60, P < 0.001), after the first exercise stage (r = 0.79, P < 0.001), and after the second exercise stage (r = 0.86, P < 0.001). Absolute agreement was found at baseline and after both bouts of exercise; ES Oxi overestimated baseline and stage 1 exercise cardiac output by 0.3 L/minute and 0.1 L/minute, respectively, but exactly estimated stage 2 exercise cardiac output. Conclusion ES-BC and ES Oxi accurately assessed body composition and cardiac output compared to standardized instruments, whereas EIS

  14. Accurate measurement of oxygen consumption in children undergoing cardiac catheterization.

    PubMed

    Li, Jia

    2013-01-01

    Oxygen consumption (VO(2) ) is an important part of hemodynamics using the direct Fick principle in children undergoing cardiac catheterization. Accurate measurement of VO(2) is vital. Obviously, any error in the measurement of VO(2) will translate directly into an equivalent percentage under- or overestimation of blood flows and vascular resistances. It remains common practice to estimate VO(2) values from published predictive equations. Among these, the LaFarge equation is the most commonly used equation and gives the closest estimation with the least bias and limits of agreement. However, considerable errors are introduced by the LaFarge equation, particularly in children younger than 3 years of age. Respiratory mass spectrometry remains the "state-of-the-art" method, allowing highly sensitive, rapid and simultaneous measurement of multiple gas fractions. The AMIS 2000 quadrupole respiratory mass spectrometer system has been adapted to measure VO(2) in children under mechanical ventilation with pediatric ventilators during cardiac catheterization. The small sampling rate, fast response time and long tubes make the equipment a unique and powerful tool for bedside continuous measurement of VO(2) in cardiac catheterization for both clinical and research purposes. PMID:22488802

  15. Scale-Independent Measures and Pathologic Cardiac Dynamics

    NASA Astrophysics Data System (ADS)

    Amaral, Luís A.; Goldberger, Ary L.; Ivanov, Plamen Ch.; Stanley, H. Eugene

    1998-09-01

    We study several scale-independent measures of cardiac interbeat interval dynamics defined through the application of the wavelet transform. We test their performance in detecting heart disease using a database consisting of records of interbeat intervals for a group of healthy individuals and subjects with congestive heart failure. We find that scale-independent measures effectively distinguish healthy from pathologic behavior and propose a new two-variable scale-independent measure that could be clinically useful. We compare the performance of a recently proposed scale-dependent measure and find that the results depend on the database analyzed and on the analyzing wavelet.

  16. Use of a capillary input function with cardiac output for the estimation of lesion pharmacokinetic parameters: preliminary results on a breast cancer patient

    NASA Astrophysics Data System (ADS)

    Di Giovanni, P.; Ahearn, T. S.; Semple, S. I.; Azlan, C. A.; Lloyd, W. K. C.; Gilbert, F. J.; Redpath, T. W.

    2011-03-01

    The objective of this work was to propose and demonstrate a novel technique for the assessment of tumour pharmacokinetic parameters together with a regionally estimated vascular input function. A breast cancer patient T2*-weighted dynamic contrast enhanced MRI (DCE-MRI) dataset acquired at high temporal resolution during the first-pass bolus perfusion was used for testing the technique. Extraction of the lesion volume transfer constant Ktrans together with the intravascular plasma volume fraction vp was achieved by optimizing a capillary input function with a measure of cardiac output using the principle of intravascular indicator dilution theory. For a region of interest drawn within the breast lesion a vp of 0.16 and a Ktrans of 0.70 min-1 were estimated. Despite the value of vp being higher than expected, estimated Ktrans was in accordance with the literature values. In conclusion, the technique proposed here, has the main advantage of allowing the estimation of breast tumour pharmacokinetic parameters from first-pass perfusion T2*-weighted DCE-MRI data without the need of measuring an arterial input function. The technique may also have applicability to T1-weighted DCE-MRI data.

  17. Measuring the mechanical efficiency of a working cardiac muscle sample at body temperature using a flow-through calorimeter.

    PubMed

    Taberner, Andrew J; Johnston, Callum M; Pham, Toan; June-Chiew Han; Ruddy, Bryan P; Loiselle, Denis S; Nielsen, Poul M F

    2015-08-01

    We have developed a new `work-loop calorimeter' that is capable of measuring, simultaneously, the work-done and heat production of isolated cardiac muscle samples at body temperature. Through the innovative use of thermoelectric modules as temperature sensors, the development of a low-noise fluid-flow system, and implementation of precise temperature control, the heat resolution of this device is 10 nW, an improvement by a factor of ten over previous designs. These advances have allowed us to conduct the first flow-through measurements of work output and heat dissipation from cardiac tissue at body temperature. The mechanical efficiency is found to vary with peak stress, and reaches a peak value of approximately 15 %, a figure similar to that observed in cardiac muscle at lower temperatures. PMID:26738140

  18. The effects of cardiac output and pulmonary arterial hypertension on volumetric capnography derived-variables during normoxia and hypoxia.

    PubMed

    Mosing, Martina; Kutter, Annette P N; Iff, Samuel; Raszplewicz, Joanna; Mauch, Jacqueline; Bohm, Stephan H; Tusman, Gerardo

    2015-02-01

    The aim of this study was to test the effect of cardiac output (CO) and pulmonary artery hypertension (PHT) on volumetric capnography (VCap) derived-variables. Nine pigs were mechanically ventilated using fixed ventilatory settings. Two steps of PHT were induced by IV infusion of a thromboxane analogue: PHT25 [mean pulmonary arterial pressure (MPAP) of 25 mmHg] and PHT40 (MPAP of 40 mmHg). CO was increased by 50% from baseline (COup) with an infusion of dobutamine≥5 μg kg(-1) min(-1) and decreased by 40% from baseline (COdown) infusing sodium nitroglycerine≥30 μg kg(-1) min(-1) plus esmolol 500 μg kg(-1) min(-1). Another state of PHT and COdown was induced by severe hypoxemia (FiO2 0.07). Invasive hemodynamic data and VCap were recorded and compared before and after each step using a mixed random effects model. Compared to baseline, the normalized slope of phase III (SnIII) increased by 32% in PHT25 and by 22% in PHT40. SnIII decreased non-significantly by 4% with COdown. A combination of PHT and COdown associated with severe hypoxemia increased SnIII by 28% compared to baseline. The elimination of CO2 per breath decreased by 7% in PHT40 and by 12% in COdown but increased only slightly with COup. Dead space variables did not change significantly along the protocol. At constant ventilation and body metabolism, pulmonary artery hypertension and decreases in CO had the biggest effects on the SnIII of the volumetric capnogram and on the elimination of CO2. PMID:24908108

  19. CARDIO--a Lotus 1-2-3 based computer program for rapid calculation of cardiac output from dye or thermal dilution curves.

    PubMed

    Brill, R W; Bushnell, P G

    1989-01-01

    We have developed a menu-driven computer program (CARDIO), based on a Lotus 1-2-3 template and a series of macrocommands, that rapidly and semiautomatically calculates cardiac output from dye or thermal dilution curves. CARDIO works with any dye or thermal dilution recorder with an analog output, any analog to digital (A-to-D) conversion system, and any computer capable of running Lotus 1-2-3 version 2. No prior experience with Lotus 1-2-3 is needed to operate CARDIO, but experienced users can take full advantage of Lotus 1-2-3's graphics, data manipulation, and data retrieval capabilities. PMID:2689079

  20. Pericardial Fat and Echocardiographic Measures of Cardiac Abnormalities

    PubMed Central

    Liu, Jiankang; Fox, Caroline S.; Hickson, DeMarc A.; May, Warren L.; Ding, Jingzhong; Carr, J. Jeffery; Taylor, Herman A.

    2011-01-01

    OBJECTIVE Pericardial adipose tissue (PAT), a regional fat depot adjacent to the myocardium, may mediate the complex relation between obesity and cardiac left ventricular (LV) abnormalities. We sought to evaluate the association of PAT with echocardiographic measures of LV abnormalities in the Jackson Heart Study (JHS). RESEARCH DESIGN AND METHODS A total of 1,414 African Americans (35% men; mean age 58 years) from the JHS underwent computed tomographic assessment of PAT and abdominal visceral adipose tissue (VAT) from 2007 to 2009 and echocardiography examination between 2000 and 2004. Echocardiographic measures of left atrial (LA) internal diameter, LV mass, LV ejection fraction (LVEF), and E-wave velocity-to-A-wave velocity ratio (E/A ratio) were examined in relation to PAT, VAT, BMI, and waist circumference (WC). RESULTS All adiposity measures were positively correlated with LA diameter and LV mass and negatively correlated with E/A ratio (P = 0.02 to 0.0001) and were not with LVEF (P = 0.36–0.61). In women, per 1-SD increment of PAT, we observed association with higher LV mass (9.0 ± 1.7 gm, P = 0.0001) and LA diameter (1.0 ± 0.1 mm, P = 0.0001). However, the magnitude of the association between PAT and cardiac measures was similar compared with VAT (P = 0.65 [LV mass]; P = 0.26 [LA diameter]) and was smallercompared with BMI (P = 0.002 [LV mass]; P = 0.01 [LA diameter]) and WC (P = 0.009 [LA diameter]). CONCLUSIONS PAT is correlated with echocardiographic measures of cardiac LV abnormalities, but the association is not stronger than other adiposity measures. PMID:21228247

  1. 40 CFR 92.116 - Engine output measurement system calibrations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... calibration. (1) The engine flywheel torque and engine speed measurement transducers shall be calibrated with the calibration equipment described in this section. (2) The engine flywheel torque feedback signals... engineering practice. (4) When calibrating the engine flywheel torque transducer, any lever arm used...

  2. 40 CFR 92.116 - Engine output measurement system calibrations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... calibration. (1) The engine flywheel torque and engine speed measurement transducers shall be calibrated with the calibration equipment described in this section. (2) The engine flywheel torque feedback signals... engineering practice. (4) When calibrating the engine flywheel torque transducer, any lever arm used...

  3. 40 CFR 92.116 - Engine output measurement system calibrations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... calibration. (1) The engine flywheel torque and engine speed measurement transducers shall be calibrated with the calibration equipment described in this section. (2) The engine flywheel torque feedback signals... engineering practice. (4) When calibrating the engine flywheel torque transducer, any lever arm used...

  4. Measurement and Modeling of Solar and PV Output Variability: Preprint

    SciTech Connect

    Sengupta, M.

    2011-04-01

    This paper seeks to understand what temporal and spatial scales of variability in global horizontal radiation are important to a PV plants and what measurements are needed to be able to characterize them. As solar radiation measuring instruments are point receivers it is important to understand how those measurements translate to energy received over a larger spatial extent. Also of importance is the temporal natural of variability over large spatial areas. In this research we use high temporal and spatial resolution measurements from multiple sensors at a site in Hawaii to create solar radiation fields at various spatial and temporal scales. Five interpolation schemes were considered and the high resolution solar fields were converted to power production for a PV power plant. It was found that the interpolation schemes are robust and create ramp distributions close to what would be computed if the average solar radiation field was used. We also investigated the possibility of using time averaged solar data from 1 sensor to recreate the ramp distribution from the 17 sensors. It was found that the ramping distribution from using appropriately time averaged data from 1 sensor can reasonably match the distribution created using the 17 sensor network.

  5. Measuring technical efficiency of output quality in intensive care units.

    PubMed

    Junoy, J P

    1997-01-01

    Presents some examples of the implications derived from imposing the objective of maximizing social welfare, subject to limited resources, on ethical care patients management in respect of quality performance of health services. Conventional knowledge of health economics points out that critically ill patients are responsible for increased use of technological resources and that they receive a high proportion of health care resources. Attempts to answer, from the point of view of microeconomics, the question: how do we measure comparative efficiency in the management of intensive care units? Analyses this question through data from an international empirical study using micro-economic measures of productive efficiency in public services (data envelopment analysis). Results show a 28.8 per cent level of technical inefficiency processing data from 25 intensive care units in the USA. PMID:10169231

  6. In vivo measurement of muscle output in intact Drosophila.

    PubMed

    Elliott, Christopher J H; Sparrow, John C

    2012-01-01

    We describe our methods for analysing muscle function in a whole intact small insect, taking advantage of a simple flexible optical beam to produce an inexpensive transducer with wide application. We review our previous data measuring the response to a single action potential driven muscle twitch to explore jumping behaviour in Drosophila melanogaster. In the fruitfly, where the sophisticated and powerful genetic toolbox is being widely employed to investigate neuromuscular function, we further demonstrate the use of the apparatus to analyse in detail, within whole flies, neuronal and muscle mutations affecting activation of muscle contraction in the jump muscle. We have now extended the use of the apparatus to record the muscle forces during larval and other aspects of adult locomotion. The robustness, simplicity and versatility of the apparatus are key to these measurements. PMID:22037247

  7. An efficient method of measuring the 4 mm helmet output factor for the Gamma Knife

    NASA Astrophysics Data System (ADS)

    Ma, Lijun; Li, X. Allen; Yu, Cedric X.

    2000-03-01

    It is essential to have accurate measurements of the 4 mm helmet output factor in the treatment of trigeminal neuralgia patients using the Gamma Knife. Because of the small collimator size and the sharp dose gradient at the beam focus, this measurement is generally tedious and difficult. We have developed an efficient method of measuring the 4 mm helmet output factor using regular radiographic films. The helmet output factor was measured by exposing a single Kodak XV film in the standard Leksell spherical phantom using the 18 mm helmet with 30-40 of its plug collimators replaced by the 4 mm plug collimators. The 4 mm helmet output factor was measured to be 0.876 ± 0.009. This is in excellent agreement with our EGS4 Monte Carlo simulated value of 0.876 ± 0.005. This helmet output factor value also agrees with more tedious TLD, diode and radiochromic film measurements that were each obtained using two separate measurements with the 18 mm helmet and the 4 mm helmet respectively. The 4 mm helmet output factor measured by the diode was 0.884 ± 0.016, and the TLD measurement was 0.890 ± 0.020. The radiochromic film measured value was 0.870 ± 0.018. Because a single-exposure measurement was performed instead of a double-exposure measurement, most of the systematic errors that appeared in the double-exposure measurements due to experimental setup variations were cancelled out. Consequently, the 4 mm helmet output factor is more precisely determined by the single-exposure approach. Therefore, routine measurement and quality assurance of the 4 mm helmet output factor of the Gamma Knife could be efficiently carried out using the proposed single-exposure technique.

  8. Nexfin Noninvasive Continuous Hemodynamic Monitoring: Validation against Continuous Pulse Contour and Intermittent Transpulmonary Thermodilution Derived Cardiac Output in Critically Ill Patients

    PubMed Central

    Van De Vijver, Katrijn; De laet, Inneke; Schoonheydt, Karen; Dits, Hilde; Bein, Berthold; Malbrain, Manu L. N. G.

    2013-01-01

    Introduction. Nexfin (Bmeye, Amsterdam, Netherlands) is a noninvasive cardiac output (CO) monitor based on finger arterial pulse contour analysis. The aim of this study was to validate Nexfin CO (NexCO) against thermodilution (TDCO) and pulse contour CO (CCO) by PiCCO (Pulsion Medical Systems, Munich, Germany). Patients and Methods. In a mix of critically ill patients (n = 45), NexCO and CCO were measured continuously and recorded at 2-hour intervals during the 8-hour study period. TDCO was measured at 0–4–8 hrs. Results. NexCO showed a moderate to good (significant) correlation with TDCO (R2 0.68, P < 0.001) and CCO (R2 0.71, P < 0.001). Bland and Altman analysis comparing NexCO with TDCO revealed a bias (± limits of agreement, LA) of 0.4 ± 2.32 L/min (with 36% error) while analysis comparing NexCO with CCO showed a bias (±LA) of 0.2 ± 2.32 L/min (37% error). NexCO is able to follow changes in TDCO and CCO during the same time interval (level of concordance 89.3% and 81%). Finally, polar plot analysis showed that trending capabilities were acceptable when changes in NexCO (ΔNexCO) were compared to ΔTDCO and ΔCCO (resp., 89% and 88.9% of changes were within the level of 10% limits of agreement). Conclusion. we found a moderate to good correlation between CO measurements obtained with Nexfin and PiCCO. PMID:24319373

  9. Characterization of a flow-through microcalorimeter for measuring the heat production of cardiac trabeculae

    NASA Astrophysics Data System (ADS)

    Taberner, A. J.; Hunter, I. W.; Kirton, R. S.; Nielsen, P. M. F.; Loiselle, D. S.

    2005-10-01

    The energy consumption of isolated cardiac trabeculae can be inferred from measurements of their heat production. Once excised from the heart, to remain viable, trabeculae require continuous superfusion with an oxygen- and nutrient-rich solution. Flow-through calorimeters enable trabeculae to be maintained in a stable and controlled environment for many hours at a time. In this paper we describe and characterize a flow-through microcalorimeter, with sensitivity in the 1μW range, for measuring the heat output of 10μg cardiac trabeculae. The device uses infrared-sensitive, thin-film thermopile sensors to provide a noncontact method for measuring temperature differences. The sensors are capable of resolving 5μK temperature differences within the superfusing fluid. The microcalorimeter has a sensitivity of 2.56V/W at a flow rate of 1μl/s, with a time constant of approximately 3.5 s. The sensitivity and time constant are strongly dependent upon the flow rate. Predictions of a finite-element model of the calorimeter's characteristics compare favorably with measured data over a wide range of flow rates.

  10. Kids Count: Using Output Measures to Monitor Children's Use of Reference Services.

    ERIC Educational Resources Information Center

    Walter, Virginia A.

    1995-01-01

    Examines three publications as guides for evaluating library reference services and the potential of one for the development of children's services. Highlights include public library planning, limitations, output measures for children's materials and information services, and the library role. (AEF)

  11. Feasibility of measuring superior mesenteric artery blood flow during cardiac surgery under hypothermic cardiopulmonary bypass using transesophageal echocardiography: An observational study

    PubMed Central

    Singh, Naveen G.; Nagaraja, P. S.; Gopal, Divya; Manjunath, V.; Nagesh, K. S.; Manjunatha, N.; Patel, Guru Police; Mishra, Satish Kumar

    2016-01-01

    Background: Abdominal complications being rare but results in high mortality, commonly due to splanchnic organ hypoperfusion during the perioperative period of cardiac surgery. There are no feasible methods to monitor intraoperative superior mesenteric artery blood flow (SMABF). Hence, the aim of this study was to evaluate the feasibility and to measure SMABF using transesophageal echocardiography (TEE) during cardiac surgery under hypothermic cardiopulmonary bypass (CPB). Methodology: Thirty-five patients undergoing elective cardiac surgery under CPB were enrolled. Heart rate, mean arterial pressure (MAP), cardiac output (CO), SMABF, superior mesenteric artery (SMA) diameter, superior mesentric artery blood flow over cardiac output (SMA/CO) ratio and arterial blood lactates were recorded at three time intervals. T0: before sternotomy, T1: 30 min after initiation of CPB and T2: after sternal closure. Results: SMA was demonstrated in 32 patients. SMABF, SMA diameter, SMA/CO, MAP and CO decreased significantly (P < 0.0001) between T0 and T1, increased significantly (P ≤ 0.001) between T0 and T2. Lactates increased progressively from T0 to T2. Conclusion: Study shows that there is decrease in SMABF during CPB and returns to baseline after CPB. Hence, it is feasible to measure SMABF using TEE in patients undergoing cardiac surgery under hypothermic CPB. TEE can be a promising tool in detecting and preventing splanchnic hypoperfusion during perioperative period. PMID:27397442

  12. The effect of small field output factor measurements on IMRT dosimetry

    SciTech Connect

    Azimi, Rezvan; Alaei, Parham; Higgins, Patrick

    2012-08-15

    Purpose: To evaluate how changes in the measured small field output factors affect the doses in intensity-modulated treatment planning. Methods: IMRT plans were created using Philips Pinnacle treatment planning system. The plans were optimized to treat a cylindrical target 2 cm in diameter and 2 cm in length. Output factors for 2 Multiplication-Sign 2 and 3 Multiplication-Sign 3 cm{sup 2} field sizes were changed by {+-}5%, {+-}10%, and {+-}20% increments from the baseline measurements and entered into the planning system. The treatment units were recommissioned in the treatment planning system after each modification of the output factors and treatment plans were reoptimized. All plans were delivered to a solid water phantom and dose measurements were made using an ionization chamber. The percentage differences between measured and computed doses were calculated. An Elekta Synergy and a Varian 2300CD linear accelerator were separately evaluated. Results: For the Elekta unit, decreasing the output factors resulted in higher measured than computed doses by 0.8% for -5%, 3.6% for -10%, and 8.7% for -20% steps. Increasing the output factors resulted in lower doses by 2.9% for +5%, 5.4% for +10%, and 8.3% for +20% steps. For the Varian unit no changes were observed for either increased or decreased output factors. Conclusions: The measurement accuracy of small field output factors are of importance especially when the treatment plan consists of small segments as in IMRT. The method proposed here could be used to verify the accuracy of the measured small field output factors for certain linear accelerators as well as to test the beam model. The Pinnacle treatment planning system model uses output factors as a function of jaw setting. Consequently, plans using the Elekta unit, which conforms the jaws to the segments, are sensitive to small field measurement accuracy. On the other hand, for the Varian unit, jaws are fixed and segments are modeled as blocked fields hence

  13. Dynamic Measurement of Hemodynamic Parameters and Cardiac Preload in Adults with Dengue: A Prospective Observational Study

    PubMed Central

    Thanachartwet, Vipa; Wattanathum, Anan; Sahassananda, Duangjai; Wacharasint, Petch; Chamnanchanunt, Supat; Khine Kyaw, Ei; Jittmittraphap, Akanitt; Naksomphun, Mali; Surabotsophon, Manoon; Desakorn, Varunee

    2016-01-01

    Few previous studies have monitored hemodynamic parameters to determine the physiological process of dengue or examined inferior vena cava (IVC) parameters to assess cardiac preload during the clinical phase of dengue. From January 2013 to July 2015, we prospectively studied 162 hospitalized adults with confirmed dengue viral infection using non-invasive cardiac output monitoring and bedside ultrasonography to determine changes in hemodynamic and IVC parameters and identify the types of circulatory shock that occur in patients with dengue. Of 162 patients with dengue, 17 (10.5%) experienced dengue shock and 145 (89.5%) did not. In patients with shock, the mean arterial pressure was significantly lower on day 6 after fever onset (P = 0.045) and the pulse pressure was significantly lower between days 4 and 7 (P<0.05). The stroke volume index and cardiac index were significantly decreased between days 4 and 15 and between days 5 and 8 after fever onset (P<0.05), respectively. A significant proportion of patients with dengue shock had an IVC diameter <1.5 cm and IVC collapsibility index >50% between days 4 and 5 (P<0.05). Hypovolemic shock was observed in 9 (52.9%) patients and cardiogenic shock in 8 (47.1%), with a median (interquartile range) time to shock onset of 6.0 (5.0–6.5) days after fever onset, which was the median day of defervescence. Intravascular hypovolemia occurred before defervescence, whereas myocardial dysfunction occurred on the day of defervescence until 2 weeks after fever onset. Hypovolemic shock and cardiogenic shock each occurred in approximately half of the patients with dengue shock. Therefore, dynamic measures to estimate changes in hemodynamic parameters and preload should be monitored to ensure adequate fluid therapy among patients with dengue, particularly patients with dengue shock. PMID:27196051

  14. Effects of chronic hypoxia on cardiac function measured by pressure-volume catheter in fetal chickens

    PubMed Central

    Giraud, George D.; Espinoza, Herbert M.; Davis, Erica N.; Crossley, Dane A.

    2015-01-01

    Hypoxia is a common component of many developmental insults and has been studied in early-stage chicken development. However, its impact on cardiac function and arterial-ventricular coupling in late-stage chickens is relatively unknown. To test the hypothesis that hypoxic incubation would reduce baseline cardiac function but protect the heart during acute hypoxia in late-stage chickens, white Leghorn eggs were incubated at 21% O2 or 15% O2. At 90% of incubation (19 days), hypoxic incubation caused growth restriction (−20%) and increased the LV-to-body ratio (+41%). Left ventricular (LV) pressure-volume loops were measured in anesthetized chickens in normoxia and acute hypoxia (10% O2). Hypoxic incubation lowered the maximal rate of pressure generation (ΔP/ΔtMax; −22%) and output (−57%), whereas increasing end-systolic elastance (ELV; +31%) and arterial elastance (EA; +122%) at similar heart rates to normoxic incubation. Both hypoxic incubation and acute hypoxia lengthened the half-time of relaxation (τ; +24%). Acute hypoxia reduced heart rate (−8%) and increased end-diastolic pressure (+35%). Hearts were collected for mRNA analysis. Hypoxic incubation was marked by decreased mRNA expression of sarco(endo)plasmic reticulum Ca2+-ATPase 2, Na+/Ca2+ exchanger 1, phospholamban, and ryanodine receptor. In summary, hypoxic incubation reduces LV function in the late-stage chicken by slowing pressure generation and relaxation, which may be driven by altered intracellular excitation-contraction coupling. Cardiac efficiency is greatly reduced after hypoxic incubation. In both incubation groups acute hypoxia reduced diastolic function. PMID:25652537

  15. Input-output relations in biological systems: measurement, information and the Hill equation

    PubMed Central

    2013-01-01

    Biological systems produce outputs in response to variable inputs. Input-output relations tend to follow a few regular patterns. For example, many chemical processes follow the S-shaped Hill equation relation between input concentrations and output concentrations. That Hill equation pattern contradicts the fundamental Michaelis-Menten theory of enzyme kinetics. I use the discrepancy between the expected Michaelis-Menten process of enzyme kinetics and the widely observed Hill equation pattern of biological systems to explore the general properties of biological input-output relations. I start with the various processes that could explain the discrepancy between basic chemistry and biological pattern. I then expand the analysis to consider broader aspects that shape biological input-output relations. Key aspects include the input-output processing by component subsystems and how those components combine to determine the system’s overall input-output relations. That aggregate structure often imposes strong regularity on underlying disorder. Aggregation imposes order by dissipating information as it flows through the components of a system. The dissipation of information may be evaluated by the analysis of measurement and precision, explaining why certain common scaling patterns arise so frequently in input-output relations. I discuss how aggregation, measurement and scale provide a framework for understanding the relations between pattern and process. The regularity imposed by those broader structural aspects sets the contours of variation in biology. Thus, biological design will also tend to follow those contours. Natural selection may act primarily to modulate system properties within those broad constraints. Reviewers This article was reviewed by Eugene Koonin, Georg Luebeck and Sergei Maslov. PMID:24308849

  16. Prediction of betavoltaic battery output parameters based on SEM measurements and Monte Carlo simulation.

    PubMed

    Yakimov, Eugene B

    2016-06-01

    An approach for a prediction of (63)Ni-based betavoltaic battery output parameters is described. It consists of multilayer Monte Carlo simulation to obtain the depth dependence of excess carrier generation rate inside the semiconductor converter, a determination of collection probability based on the electron beam induced current measurements, a calculation of current induced in the semiconductor converter by beta-radiation, and SEM measurements of output parameters using the calculated induced current value. Such approach allows to predict the betavoltaic battery parameters and optimize the converter design for any real semiconductor structure and any thickness and specific activity of beta-radiation source. PMID:27017084

  17. Measurement of dynamic gas disengagement profile by using an analog output level gauge

    NASA Astrophysics Data System (ADS)

    Mikkilineni, S.; Koelle, M.; Xu, H.

    The dynamic gas disengagement profile was measured in a 0.14 m diameter and 3.66 m high plexiglas column by using an analog output gauge, which was connected to a data acquisition system. This analog output gauge is a high accuracy continuous measurement level gauge. It is made up of a wave guide, a float, a motion or stress sensing device and a probe housing. The fluid level at any gas velocity is obtained by using the data acquisition system. The dynamic gas disengagement profile produced one slope in the bubble flow and two slopes in the churn turbulent flow representing unimodal and bimodal distributions of bubbles.

  18. SU-E-T-257: Output Constancy: Reducing Measurement Variations in a Large Practice Group

    SciTech Connect

    Hedrick, K; Fitzgerald, T; Miller, R

    2014-06-01

    Purpose: To standardize output constancy check procedures in a large medical physics practice group covering multiple sites, in order to identify and reduce small systematic errors caused by differences in equipment and the procedures of multiple physicists. Methods: A standardized machine output constancy check for both photons and electrons was instituted within the practice group in 2010. After conducting annual TG-51 measurements in water and adjusting the linac to deliver 1.00 cGy/MU at Dmax, an acrylic phantom (comparable at all sites) and PTW farmer ion chamber are used to obtain monthly output constancy reference readings. From the collected charge reading, measurements of air pressure and temperature, and chamber Ndw and Pelec, a value we call the Kacrylic factor is determined, relating the chamber reading in acrylic to the dose in water with standard set-up conditions. This procedure easily allows for multiple equipment combinations to be used at any site. The Kacrylic factors and output results from all sites and machines are logged monthly in a central database and used to monitor trends in calibration and output. Results: The practice group consists of 19 sites, currently with 34 Varian and 8 Elekta linacs (24 Varian and 5 Elekta linacs in 2010). Over the past three years, the standard deviation of Kacrylic factors measured on all machines decreased by 20% for photons and high energy electrons as systematic errors were found and reduced. Low energy electrons showed very little change in the distribution of Kacrylic values. Small errors in linac beam data were found by investigating outlier Kacrylic values. Conclusion: While the use of acrylic phantoms introduces an additional source of error through small differences in depth and effective depth, the new standardized procedure eliminates potential sources of error from using many different phantoms and results in more consistent output constancy measurements.

  19. [Application of a Fotonic Sensor for measurement of chronotropy and contractility in cultured rat cardiac myocytes].

    PubMed

    Kawana, S; Kimura, H; Miyamoto, A; Ohshika, H; Namiki, A

    1993-10-01

    We used a Fotonic Sensor, a fiber optic displacement measurement instrument, to measure the chronotropy and the contractility of cultured neonatal rat cardiac myocytes. The principle of the measurement is to detect changes in the distance between the probe and myocytes vertically extruded by the contraction. A fiber optic probe consists of adjacent pairs of light-transmitting and light-receiving fibers. The ratio of reflected light to transmitted light changes proportionally to the distance between the probe and an object at a certain range shown in a calibration curve. The analogue output from the sensor was transferred to a personal computer through an analogue/digital converter and analyzed. The sensor was able to detect the rate of myocyte beating, i.e., chronotropy, with a high correlation to the frequency of electrically stimulated beating and agreed well with the beating rate counted visually under a microscope. The contractility was evaluated by the maximum contraction velocity (Vm) by the first derivatives of the contraction curves obtained by the sensor. Norepinephrine (NE) and isoproterenol (ISO) increased the contractility in cultured myocytes in a dose-dependent fashion. In the preparation of rat ventricular papillary muscle, NE- and ISO-induced increase in the Vm in the radial direction significantly correlated with the increase in tension measured with a force-displacement transducer. These results indicate that the Fotonic Sensor is an appropriate instrument for evaluating the chronotropy and the contractility of cultured myocytes. PMID:8253432

  20. A particle image velocimeter for measuring the output of high energy detonators

    SciTech Connect

    Murphy, Michael J; Adrian, Ronald J; Clarke, Steven A

    2010-01-01

    Results from feasibility experiments are presented to confirm that tracer-particle motion resulting from mass-velocity fields created by driving high-energy detonator output into dynamic witness plates can be successfully measured using particle image velocimetry (PIV). Experimental results, application challenges, and PIV system development are presented. In shock mechanics research, the ability to quantitatively measure the state of compression of shocked materials in two and three dimensions based on particle tracer methods is of extreme importance since such measurements provide precise temporal snapshots of two and three-dimensional shock-induced velocity fields. This is especially true in the science of detonation physics where such measurements provide enormous insight into fundamental. questions for understanding shock-loading processes, effects of shock-front curvature, and mechanisms of energy conversion from stimulus to shock output. As an example, answering such questions is paramount to the understanding and development of newer, safer detonators. To date, few attempts have been made to develop and implement standard particle tracer techniques to measure shock-induced flows resulting from explosive devices. The experimental challenge lies in developing a methodology wherein a tracer particle's inertia does not hinder its ability to accurately move with the rapidly changing flow field. We have recently developed the ability to characterize the output of unloaded explosive initiators (e.g. exploding bridge wires, exploding foils, laser-driven plasmas, etc.) using an optically-based diagnostic consisting of an ultra-high speed, time-resolved PIV system and inert, transparent polymers serving as dynamic witness plates. Initiator output is directed into a witness plate, and measurements of shock and mass velocities are made in a two-dimensional plane aligned with the initiator centerline. The results allow initiator output to be quantified in any in

  1. Statistics & Input-Output Measures for School Library Media Centers in Colorado, 2000.

    ERIC Educational Resources Information Center

    Lance, Keith Curry; Rodney, Marcia J.; Steffen, Nicolle

    This document contains statistics and input-output measures for Colorado school libraries and media centers. High schools, middle/junior high schools, and elementary schools are each subdivided into sections by population. Each section includes the school identification (district, address, city, county, zip code); respondent identification (name,…

  2. Statistics & Input-Output Measures for School Libraries in Colorado, 2002.

    ERIC Educational Resources Information Center

    Colorado State Library, Denver.

    This document presents statistics and input-output measures for K-12 school libraries in Colorado for 2002. Data are presented by type and size of school, i.e., high schools (six categories ranging from 2,000 and over to under 300), junior high/middle schools (five categories ranging from 1,000-1,999 to under 300), elementary schools (four…

  3. Measures of endothelial dysfunction predict response to cardiac resynchronisation therapy

    PubMed Central

    Warriner, David R; Lawford, Patricia; Sheridan, Paul J

    2016-01-01

    Objectives Cardiac resynchronisation therapy (CRT) improves morbidity and mortality in heart failure (HF). Impaired endothelial function, as measured by flow-mediated dilation (FMD) is associated with increased morbidity and mortality in HF and may help to differentiate responders from non-responders. Methods 19 patients were recruited, comprising 94% men, mean age 69±8 years, New York Heart Association functional classes II–IV, QRSd 161±21 ms and mean left ventricular ejection fraction 26±8%. Markers of response and FMD were measured at baseline, 6 and 12 months following CRT. Results 14 patients were responders to CRT. Responders had significant improvements in VO2 (12.6±1.7 to 14.7±1.5 mL/kg/min, p<0.05), quality of life score (44.4±22.9–24.1±21.3, p<0.01), left ventricular end diastolic volume (201.5±72.5 mL–121.3±72.0 mL, p<0.01) and 6-min walk distance (374.0±112.8 m at baseline to 418.1±105.3 m, p<0.05). Baseline FMD in responders was 2.9±1.9% and 7.4±3.73% in non-responders (p<0.05). Conclusions Response to CRT at 6 and 12 months is predicted by baseline FMD. This study confirms that FMD identifies responders to CRT, due to endothelium-dependent mechanisms alone. PMID:27335654

  4. How One University--and Its Faculties--Respond to New National Policies on the Measurement of Research Output

    ERIC Educational Resources Information Center

    Madue, S. M.

    2008-01-01

    The production of research output has become a complex and competitive pursuit. Basic, experimental and strategic research compete more for scarce state and donor funding. In the Republic of South Africa (South Africa), research output is recognised through government subsidy-earnings guided by the policy for the measurement of research output of…

  5. Measurement of cardiac reserve in cardiogenic shock: implications for prognosis and management.

    PubMed Central

    Tan, L B; Littler, W A

    1990-01-01

    The hypothesis that the prognosis of cardiogenic shock patients is primarily dependent on cardiac pumping reserve was tested in a prospective study of 28 consecutive patients clinically diagnosed to be in cardiogenic shock and treated medically. Haemodynamic function was assessed by thermodilution Swan-Ganz catheters and arterial cannulas. The cardiac pumping reserve was evaluated by the response of the failing heart to graded incremental dobutamine infusion (2.5 to 40 micrograms/kg/min) after optimalising the left ventricular preload. Eleven of the patients survived for more than the one year of follow up and the rest died. Haemodynamic evaluation during the basal resting state was only able to identify unambiguously non-survivors whose cardiac function was most severely compromised. Survivors and non-survivors with higher values were indistinguishable by basal haemodynamic criteria. The response to dobutamine stimulation clearly separated the cardiac pump function of survivors and those who died. All patients with peak cardiac power output of less than 1.0 W or peak left ventricular stroke work index of less than 0.25 J/m2 died whereas all those with higher values lived for more than a year. Thus this study showed that haemodynamic evaluation of cardiac reserve can provide objective criteria for predicting outcome in individual patients with cardiogenic shock. The availability of such a prognostic indicator will be invaluable in formulating management plans for these patients. PMID:2393609

  6. Clinical use of diodes and micro-chambers to obtain accurate small field output factor measurements.

    PubMed

    Kairn, T; Charles, P H; Cranmer-Sargison, G; Crowe, S B; Langton, C M; Thwaites, D I; Trapp, J V

    2015-06-01

    There have been substantial advances in small field dosimetry techniques and technologies, over the last decade, which have dramatically improved the achievable accuracy of small field dose measurements. This educational note aims to help radiation oncology medical physicists to apply some of these advances in clinical practice. The evaluation of a set of small field output factors (total scatter factors) is used to exemplify a detailed measurement and simulation procedure and as a basis for discussing the possible effects of simplifying that procedure. Field output factors were measured with an unshielded diode and a micro-ionisation chamber, at the centre of a set of square fields defined by a micro-multileaf collimator. Nominal field sizes investigated ranged from 6 × 6 to 98 × 98 mm(2). Diode measurements in fields smaller than 30 mm across were corrected using response factors calculated using Monte Carlo simulations of the diode geometry and daisy-chained to match micro-chamber measurements at intermediate field sizes. Diode measurements in fields smaller than 15 mm across were repeated twelve times over three separate measurement sessions, to evaluate the reproducibility of the radiation field size and its correspondence with the nominal field size. The five readings that contributed to each measurement on each day varied by up to 0.26  %, for the "very small" fields smaller than 15 mm, and 0.18 % for the fields larger than 15 mm. The diode response factors calculated for the unshielded diode agreed with previously published results, within uncertainties. The measured dimensions of the very small fields differed by up to 0.3 mm, across the different measurement sessions, contributing an uncertainty of up to 1.2 % to the very small field output factors. The overall uncertainties in the field output factors were 1.8 % for the very small fields and 1.1 % for the fields larger than 15 mm across. Recommended steps for acquiring small field output

  7. Characterization of cardiac quiescence from retrospective cardiac computed tomography using a correlation-based phase-to-phase deviation measure

    SciTech Connect

    Wick, Carson A.; McClellan, James H.; Arepalli, Chesnal D.; Auffermann, William F.; Henry, Travis S.; Khosa, Faisal; Coy, Adam M.; Tridandapani, Srini

    2015-02-15

    Purpose: Accurate knowledge of cardiac quiescence is crucial to the performance of many cardiac imaging modalities, including computed tomography coronary angiography (CTCA). To accurately quantify quiescence, a method for detecting the quiescent periods of the heart from retrospective cardiac computed tomography (CT) using a correlation-based, phase-to-phase deviation measure was developed. Methods: Retrospective cardiac CT data were obtained from 20 patients (11 male, 9 female, 33–74 yr) and the left main, left anterior descending, left circumflex, right coronary artery (RCA), and interventricular septum (IVS) were segmented for each phase using a semiautomated technique. Cardiac motion of individual coronary vessels as well as the IVS was calculated using phase-to-phase deviation. As an easily identifiable feature, the IVS was analyzed to assess how well it predicts vessel quiescence. Finally, the diagnostic quality of the reconstructed volumes from the quiescent phases determined using the deviation measure from the vessels in aggregate and the IVS was compared to that from quiescent phases calculated by the CT scanner. Three board-certified radiologists, fellowship-trained in cardiothoracic imaging, graded the diagnostic quality of the reconstructions using a Likert response format: 1 = excellent, 2 = good, 3 = adequate, 4 = nondiagnostic. Results: Systolic and diastolic quiescent periods were identified for each subject from the vessel motion calculated using the phase-to-phase deviation measure. The motion of the IVS was found to be similar to the aggregate vessel (AGG) motion. The diagnostic quality of the coronary vessels for the quiescent phases calculated from the aggregate vessel (P{sub AGG}) and IVS (P{sub IV} {sub S}) deviation signal using the proposed methods was comparable to the quiescent phases calculated by the CT scanner (P{sub CT}). The one exception was the RCA, which improved for P{sub AGG} for 18 of the 20 subjects when compared to P

  8. A constant-load ergometer for measuring peak power output and fatigue.

    PubMed

    Williams, J H; Barnes, W S; Signorile, J F

    1988-11-01

    A constant-load cycle ergometer was constructed that allows maximal power output to be measured for each one-half pedal revolution during brief, high-intensity exercise. To determine frictional force, an electronic load cell was attached to the resistance strap and the ergometer frame. Dead weights were attached to the strap's free end. Flywheel velocity was recorded by means of a magnetic switch and two magnets placed on the pedal sprocket. Pedaling resulted in magnetically activated switch closures, which produced two electronic pulses per pedal revolution. Pulses and load cell output were recorded (512 Hz), digitized, and stored on disk via microcomputer. Power output was later computed for each pair of adjacent pulses, representing average power per one-half pedal revolution. Power curves generated for each subject were analyzed for peak power output (the highest one-half pedal revolution average), time to peak power, power fatigue rate and index, average power, and total work. Thirty-eight males performed two 15-s tests separated by 15 min (n = 16) or 48 h (n = 22). Peak power output ranged from 846.0 to 1,289.1 W. Intraclass correlation analysis revealed high test-retest reliability for all parameters recorded on the same or different days (R = 0.91-0.97). No significant differences (P greater than 0.05) were noted between parameter means of the first and second tests. These results indicate that the ergometer described provides a means for conveniently and reliably assessing short-term power output and fatigue. PMID:3209578

  9. TU-F-BRE-08: Significant Variations in Measured Small Cone Output Factor for FFF Beams

    SciTech Connect

    Sudhyadhom, A; Ma, L; Kirby, N

    2014-06-15

    Purpose: To evaluate the measurement accuracy of several dosimeters for small cone output factors in two SRS/SBRT dedicated systems with Flattening Filter Free (FFF) beams: a Varian TrueBeam STx (TB) and an Accuray CyberKnife VSI (CK). Output factors (OFs) were measured for both machines and for CK, compared against a Monte Carlo model. Methods: Dose measurements were taken using three different FFF beams (TB 6XFFF, TB 10XFFF, and CK 6XFFF). Three commonly used types of dosimeters were examined in this work: a micro-ion chamber (Exradin A16), two shielded diodes (PTW TN60008 and PTW TN60017), and radiochromic film (Gafchromic EBT2). Measured OFs from these dosimeters were compared with each other and OFs measured with an Exradin W1 scintillator. Monte Carlo determined correction factors for the CK beam for the micro-ion chamber and diodes were applied to the respective OF measurements and compared against scintillator measured OFs corrected for volume averaging. Results: OFs measured for the smallest fields using the micro-ion chamber, diodes, scintillator, and film varied substantially (with up to a 16% difference between dosimeters). Micro-ion chamber and film OF measurements were up to 9% and 10%, respectively, lower than scintillator measurements for the smallest fields. OF measurements by diode were up to 6% greater than scintillator measurements for the smallest fields. With correction factors, the micro-ion chamber and diode measured OFs showed good agreement with scintillator measured OFs for the CK 6XFFF beam (within 3% and 1.5%, respectively). Conclusion: Uncorrected small field OFs vary significantly with dosimeter. The accuracy of scintillator measurements for small field OFs may be greater than the other dosimeters studied in this work (when uncorrected). Measurements involving EBT2 film may Result in lower accuracy for smaller fields (less than 10mm). Care should be taken in the choice of the dosimeter used for small field OF measurements.

  10. Using exercise to measure and modify cardiac function.

    PubMed

    Platt, Colin; Houstis, Nicholas; Rosenzweig, Anthony

    2015-02-01

    Exercise is the archetype of physiologic demands placed on the cardiovascular system. Acute responses provide an informative assessment of cardiovascular function and fitness, while repeated exercise promotes cardiovascular health and evokes important molecular, structural, and functional changes contributing to its effects in primary and secondary prevention. Here we examine the use of exercise in murine models, both as a phenotypic assay and as a provocative intervention. We first review the advantages and limitations of exercise testing for assessing cardiac function, then highlight the cardiac structural and cellular changes elicited by chronic exercise and key molecular pathways that mediate these effects. PMID:25651177

  11. A model-free method for mass spectrometer response correction. [for oxygen consumption and cardiac output calculation

    NASA Technical Reports Server (NTRS)

    Shykoff, Barbara E.; Swanson, Harvey T.

    1987-01-01

    A new method for correction of mass spectrometer output signals is described. Response-time distortion is reduced independently of any model of mass spectrometer behavior. The delay of the system is found first from the cross-correlation function of a step change and its response. A two-sided time-domain digital correction filter (deconvolution filter) is generated next from the same step response data using a regression procedure. Other data are corrected using the filter and delay. The mean squared error between a step response and a step is reduced considerably more after the use of a deconvolution filter than after the application of a second-order model correction. O2 consumption and CO2 production values calculated from data corrupted by a simulated dynamic process return to near the uncorrupted values after correction. Although a clean step response or the ensemble average of several responses contaminated with noise is needed for the generation of the filter, random noise of magnitude not above 0.5 percent added to the response to be corrected does not impair the correction severely.

  12. METHOD OF MEASURING THE INTEGRATED ENERGY OUTPUT OF A NEUTRONIC CHAIN REACTOR

    DOEpatents

    Sturm, W.J.

    1958-12-01

    A method is presented for measuring the integrated energy output of a reactor conslsting of the steps of successively irradiating calibrated thin foils of an element, such as gold, which is rendered radioactive by exposure to neutron flux for periods of time not greater than one-fifth the mean life of the induced radioactlvity and producing an indication of the radioactivity induced in each foil, each foil belng introduced into the reactor immediately upon removal of its predecessor.

  13. A device for rapid and quantitative measurement of cardiac myocyte contractility

    NASA Astrophysics Data System (ADS)

    Gaitas, Angelo; Malhotra, Ricky; Li, Tao; Herron, Todd; Jalife, José

    2015-03-01

    Cardiac contractility is the hallmark of cardiac function and is a predictor of healthy or diseased cardiac muscle. Despite advancements over the last two decades, the techniques and tools available to cardiovascular scientists are limited in their utility to accurately and reliably measure the amplitude and frequency of cardiomyocyte contractions. Isometric force measurements in the past have entailed cumbersome attachment of isolated and permeabilized cardiomyocytes to a force transducer followed by measurements of sarcomere lengths under conditions of submaximal and maximal Ca2+ activation. These techniques have the inherent disadvantages of being labor intensive and costly. We have engineered a micro-machined cantilever sensor with an embedded deflection-sensing element that, in preliminary experiments, has demonstrated to reliably measure cardiac cell contractions in real-time. Here, we describe this new bioengineering tool with applicability in the cardiovascular research field to effectively and reliably measure cardiac cell contractility in a quantitative manner. We measured contractility in both primary neonatal rat heart cardiomyocyte monolayers that demonstrated a beat frequency of 3 Hz as well as human embryonic stem cell-derived cardiomyocytes with a contractile frequency of about 1 Hz. We also employed the β-adrenergic agonist isoproterenol (100 nmol l-1) and observed that our cantilever demonstrated high sensitivity in detecting subtle changes in both chronotropic and inotropic responses of monolayers. This report describes the utility of our micro-device in both basic cardiovascular research as well as in small molecule drug discovery to monitor cardiac cell contractions.

  14. Estimating photoreceptor excitations from spectral outputs of a personal light exposure measurement device.

    PubMed

    Cao, Dingcai; Barrionuevo, Pablo A

    2015-03-01

    The intrinsic circadian clock requires photoentrainment to synchronize the 24-hour solar day. Therefore, light stimulation is an important component of chronobiological research. Currently, the chronobiological research field overwhelmingly uses photopic illuminance that is based on the luminous efficiency function, V(λ), to quantify light levels. However, recent discovery of intrinsically photosensitive retinal ganglion cells (ipRGCs), which are activated by self-contained melanopsin photopigment and also by inputs from rods and cones, makes light specification using a one-dimensional unit inadequate. Since the current understanding of how different photoreceptor inputs contribute to the circadian system through ipRGCs is limited, it is recommended to specify light in terms of the excitations of five photoreceptors (S-, M-, L-cones, rods and ipRGCs; Lucas et al., 2014). In the current study, we assessed whether the spectral outputs from a commercially available spectral watch (i.e. Actiwatch Spectrum) could be used to estimate photoreceptor excitations. Based on the color sensor spectral sensitivity functions from a previously published work, as well as from our measurements, we computed spectral outputs in the long-wavelength range (R), middle-wavelength range (G), short-wavelength range (B) and broadband range (W) under 52 CIE illuminants (25 daylight illuminants, 27 fluorescent lights). We also computed the photoreceptor excitations for each illuminant using human photoreceptor spectral sensitivity functions. Linear regression analyses indicated that the Actiwatch spectral outputs could predict photoreceptor excitations reliably, under the assumption of linear responses of the Actiwatch color sensors. In addition, R, G, B outputs could classify illuminant types (fluorescent versus daylight illuminants) satisfactorily. However, the assessment of actual Actiwatch recording under several testing light sources showed that the spectral outputs were subject to

  15. Input-output finite-time stabilisation of nonlinear stochastic system with missing measurements

    NASA Astrophysics Data System (ADS)

    Song, Jun; Niu, Yugang; Jia, Tinggang

    2016-09-01

    This paper considers the problem of the input-output finite-time stabilisation for a class of nonlinear stochastic system with state-dependent noise. The phenomenon of the missing measurements may occur when state signals are transmitted via communication networks. An estimating method is proposed to compensate the lost state information. And then, a compensator-based controller is designed to ensure the input-output finite-time stochastic stability (IO-FTSS) of the closed-loop system. Some parameters-dependent sufficient conditions are derived and the corresponding solving approach is given. Finally, numerical simulations are provided to demonstrate the feasibility and effectiveness of the developed IO-FTSS scheme.

  16. Responsiveness of Health-Related Quality of Life Outcome Measures in Cardiac Rehabilitation: Comparison of Cardiac Rehabilitation Outcome Measures

    ERIC Educational Resources Information Center

    Hevey, David; McGee, Hannah M.; Horgan, John

    2004-01-01

    Assessment instruments that are not responsive to change are unsuitable as outcome tools in cardiac rehabilitation because they underestimate the psychosocial benefits of program attendance. Nine questionnaires were assessed for responsiveness with the standardized response mean (SRM). Questionnaires were allocated into 3 batteries, and each…

  17. An updated h-index measures both the primary and total scientific output of a researcher

    PubMed Central

    Bucur, Octavian; Almasan, Alex; Zubarev, Roman; Friedman, Mark; Nicolson, Garth L.; Sumazin, Pavel; Leabu, Mircea; Nikolajczyk, Barbara S.; Avram, Dorina; Kunej, Tanja; Calin, George A.; Godwin, Andrew K.; Adami, Hans-Olov; Zaphiropoulos, Peter G.; Richardson, Des R.; Schmitt-Ulms, Gerold; Westerblad, Håkan; Keniry, Megan; Grau, Georges E. R.; Carbonetto, Salvatore; Stan, Radu V.; Popa-Wagner, Aurel; Takhar, Kasumov; Baron, Beverly W.; Galardy, Paul J.; Yang, Feng; Data, Dipak; Fadare, Oluwole; Yeo, KT Jerry; Gabreanu, Georgiana R.; Andrei, Stefan; Soare, Georgiana R.; Nelson, Mark A.; Liehn, Elisa A.

    2015-01-01

    The growing interest in scientometry stems from ethical concerns related to the proper evaluation of scientific contributions of an author working in a hard science. In the absence of a consensus, institutions may use arbitrary methods for evaluating scientists for employment and promotion. There are several indices in use that attempt to establish the most appropriate and suggestive position of any scientist in the field he/she works in. A scientist’s Hirsch-index (h-index) quantifies their total effective published output, but h-index summarizes the total value of their published work without regard to their contribution to each publication. Consequently, articles where the author was a primary contributor carry the same weight as articles where the author played a minor role. Thus, we propose an updated h-index named Hirsch(p,t)-index that informs about both total scientific output and output where the author played a primary role. Our measure, h(p,t) = h(p),h(t), is composed of the h-index h(t) and the h-index calculated for articles where the author was a key contributor; i.e. first/shared first or senior or corresponding author. Thus, a h(p,t) = 5,10 would mean that the author has 5 articles as first, shared first, senior or corresponding author with at least 5 citations each, and 10 total articles with at least 10 citations each. This index can be applied in biomedical disciplines and in all areas where the first and last position on an article are the most important. Although other indexes, such as r- and w-indexes, were proposed for measuring the authors output based on the position of researchers within the published articles, our simpler strategy uses the already established algorithms for h-index calculation and may be more practical to implement. PMID:26504901

  18. Identification of linear systems with binary output measurements using short independent experiments

    NASA Astrophysics Data System (ADS)

    Depraetere, B.; Stoev, J.; Pinte, G.; Swevers, J.

    2015-01-01

    This paper presents a novel identification technique for linear systems based on binary measurements of an analog output signal of the device under test. This type of measurement arises when the output signal is not measured directly with a high resolution sensor but it is only known whether its value exceeds a given threshold or not. The presented technique performs the estimation using a combination of many short and independent low resolution measurement runs, each of which contains only a limited amount of information. This is a significant difference with respect to the existing techniques, whose practical usefulness can be limited due to the associated requirements for long and/or periodic excitation signals. The knowledge about the binary measurement's characteristics is exploited to adapt standard prediction error minimisation techniques. This is done for both Rational Transfer Function (RTF) and Finite Impulse Response (FIR) model representations of the linear system. Simulation results are included to illustrate the identification procedure, and an experimental validation is provided to demonstrate the practical usefulness of the proposed methods.

  19. The relation between cardiac output kinetics and skeletal muscle oxygenation during moderate exercise in moderately impaired patients with chronic heart failure.

    PubMed

    Spee, Ruud F; Niemeijer, Victor M; Schoots, Thijs; Wijn, Pieter F; Doevendans, Pieter A; Kemps, Hareld M

    2016-07-01

    Oxygen uptake (V̇o2) kinetics are prolonged in patients with chronic heart failure (CHF). This may be caused by impaired oxygen delivery or skeletal muscle derangements. We investigated whether impaired cardiac output (Q̇) kinetics limit skeletal muscle oxygen delivery relative to the metabolic demands at submaximal exercise in CHF patients by evaluating the relation between Q̇ kinetics and skeletal muscle deoxygenation. Forty-three CHF patients, NYHA II-III, performed a constant-load exercise test at 80% of the ventilatory aerobic threshold (VAT) to assess V̇o2 kinetics (τV̇o2). Q̇ kinetics (τQ̇) were assessed by a radial artery pulse contour analysis method. Skeletal muscle deoxygenation was assessed by near infrared spectroscopy at the m. vastus lateralis, using the minimal value of the tissue saturation index during onset of exercise (TSImin). Patients were categorized in slow and normal Q̇ responders relative to metabolic demands (τQ̇/V̇o2 ≥1 and τQ̇/V̇o2 <1, respectively), τQ̇ (62 ± 29 s), and τV̇o2 (60 ± 21 s) were significantly related (r = 0.66, P = 0.001). There was a significant correlation between τQ̇ and TSImin in the slow Q̇ responders [rs= -0.57, P = 0.005, n = 22 (51%)]. In conclusion, in moderately impaired CHF patients with relatively slow Q̇ kinetics, central hemodynamics may limit skeletal muscle oxygenation during moderate-intensity exercise. PMID:27283909

  20. Weak values and weak coupling maximizing the output of weak measurements

    SciTech Connect

    Di Lorenzo, Antonio

    2014-06-15

    In a weak measurement, the average output 〈o〉 of a probe that measures an observable A{sup -hat} of a quantum system undergoing both a preparation in a state ρ{sub i} and a postselection in a state E{sub f} is, to a good approximation, a function of the weak value A{sub w}=Tr[E{sub f}A{sup -hat} ρ{sub i}]/Tr[E{sub f}ρ{sub i}], a complex number. For a fixed coupling λ, when the overlap Tr[E{sub f}ρ{sub i}] is very small, A{sub w} diverges, but 〈o〉 stays finite, often tending to zero for symmetry reasons. This paper answers the questions: what is the weak value that maximizes the output for a fixed coupling? What is the coupling that maximizes the output for a fixed weak value? We derive equations for the optimal values of A{sub w} and λ, and provide the solutions. The results are independent of the dimensionality of the system, and they apply to a probe having a Hilbert space of arbitrary dimension. Using the Schrödinger–Robertson uncertainty relation, we demonstrate that, in an important case, the amplification 〈o〉 cannot exceed the initial uncertainty σ{sub o} in the observable o{sup -hat}, we provide an upper limit for the more general case, and a strategy to obtain 〈o〉≫σ{sub o}. - Highlights: •We have provided a general framework to find the extremal values of a weak measurement. •We have derived the location of the extremal values in terms of preparation and postselection. •We have devised a maximization strategy going beyond the limit of the Schrödinger–Robertson relation.

  1. An innovative work-loop calorimeter for in vitro measurement of the mechanics and energetics of working cardiac trabeculae.

    PubMed

    Taberner, Andrew J; Han, June-Chiew; Loiselle, Denis S; Nielsen, Poul M F; Nielsen, Paul M F

    2011-12-01

    We describe a unique work-loop calorimeter with which we can measure, simultaneously, the rate of heat production and force-length work output of isolated cardiac trabeculae. The mechanics of the force-length work-loop contraction mimic those of the pressure-volume work-loops experienced by the heart. Within the measurement chamber of a flow-through microcalorimeter, a trabecula is electrically stimulated to respond, under software control, in one of three modes: fixed-end, isometric, or isotonic. In each mode, software controls the position of a linear motor, with feedback from muscle force, to adjust muscle length in the desired temporal sequence. In the case of a work-loop contraction, the software achieves seamless transitions between phases of length control (isometric contraction, isometric relaxation, and restoration of resting muscle length) and force control (isotonic shortening). The area enclosed by the resulting force-length loop represents the work done by the trabecula. The change of enthalpy expended by the muscle is given by the sum of the work term and the associated amount of evolved heat. With these simultaneous measurements, we provide the first estimation of suprabasal, net mechanical efficiency (ratio of work to change of enthalpy) of mammalian cardiac trabeculae. The maximum efficiency is at the vicinity of 12%. PMID:21903883

  2. Scintillator-CCD camera system light output response to dosimetry parameters for proton beam range measurement

    NASA Astrophysics Data System (ADS)

    Daftari, Inder K.; Castaneda, Carlos M.; Essert, Timothy; Phillips, Theodore L.; Mishra, Kavita K.

    2012-09-01

    The purpose of this study is to investigate the luminescence light output response in a plastic scintillator irradiated by a 67.5 MeV proton beam using various dosimetry parameters. The relationship of the visible scintillator light with the beam current or dose rate, aperture size and the thickness of water in the water-column was studied. The images captured on a CCD camera system were used to determine optimal dosimetry parameters for measuring the range of a clinical proton beam. The method was developed as a simple quality assurance tool to measure the range of the proton beam and compare it to (a) measurements using two segmented ionization chambers and water column between them, and (b) with an ionization chamber (IC-18) measurements in water. We used a block of plastic scintillator that measured 5×5×5 cm3 to record visible light generated by a 67.5 MeV proton beam. A high-definition digital video camera Moticam 2300 connected to a PC via USB 2.0 communication channel was used to record images of scintillation luminescence. The brightness of the visible light was measured while changing beam current and aperture size. The results were analyzed to obtain the range and were compared with the Bragg peak measurements with an ionization chamber. The luminescence light from the scintillator increased linearly with the increase of proton beam current. The light output also increased linearly with aperture size. The relationship between the proton range in the scintillator and the thickness of the water column showed good linearity with a precision of 0.33 mm (SD) in proton range measurement. For the 67.5 MeV proton beam utilized, the optimal parameters for scintillator light output response were found to be 15 nA (16 Gy/min) and an aperture size of 15 mm with image integration time of 100 ms. The Bragg peak depth brightness distribution was compared with the depth dose distribution from ionization chamber measurements and good agreement was observed. The peak

  3. Photonic instantaneous frequency measurement with digital output based on dispersion induced power fading functions

    NASA Astrophysics Data System (ADS)

    Chen, Ying; Yang, Bo; Chi, Hao; Jin, Xiaofeng; Zheng, Shilie; Zhang, Xianmin

    2013-04-01

    A novel photonic approach to realize the instantaneous microwave frequency measurement with digital output is proposed and demonstrated experimentally. Based on the power fading function of a double-sideband modulated microwave signal transmitting in a dispersive fiber channel, the microwave frequency to digital code mapping can be realized in a multi-channel system where each channel is configured with a predetermined amount of dispersion. The coding process involved here is similar to that of the photonic analog-to-digital conversion. The principle of the system is discussed in detail. An experiment is carried out, in which the frequency identification with 4-bit quantization levels in 17.5 GHz measurement range is demonstrated. The measurement range and the resolution are discussed theoretically and numerically.

  4. Quality-of-Life Measures for Cardiac Surgery Practice and Research: A Review and Primer

    PubMed Central

    Tully, Phillip J.

    2013-01-01

    Abstract: Declining mortality and major morbidity rates after cardiac surgery have led to increasing focus on patient quality of life (QOL). Beyond longevity, the impact of cardiac surgery on day-to-day functioning is incredibly salient to patients, their spouses, and families. As such, QOL measures are a welcome and sometimes necessary addition to clinical trials. However, how does one navigate the expansive market of QOL questionnaires, which QOL measures are applicable to cardiac surgery units, and how can they be used meaningfully in clinical practice? Because nearly two decades have passed since QOL measures were reviewed for relevance to cardiac surgery settings, an overview is provided of various generic (Short Form Health Survey [SF-36], Sickness Impact Profile, Nottingham Health Profile) and disease-specific QOL measures (Duke Activity Status Index, Seattle Angina Questionnaire, MN Living with Heart Failure Questionnaire; Heart-QOL) with examples from cardiac surgery studies. Recommendations are provided for the application of QOL measures to clinical trials and the impact on clinical decision-making is discussed. The paucity of methodologically sound QOL studies highlights the necessity for further rigorous empirical data to better inform treatment efficacy studies and clinical decision-making. PMID:23691778

  5. Heart mass and the maximum cardiac output of birds and mammals: implications for estimating the maximum aerobic power input of flying animals

    PubMed Central

    Bishop, C. M.

    1997-01-01

    Empirical studies of cardiovascular variables suggest that relative heart muscle mass (relative Mh) is a good indicator of the degree of adaptive specialization for prolonged locomotor activities, for both birds and mammals. Reasonable predictions for the maximum oxygen consumption of birds during flight can be obtained by assuming that avian heart muscle has the same maximum physiological and biomechanical performance as that of terrestrial mammals. Thus, data on Mh can be used to provide quantitative estimates for the maximum aerobic power input (aerobic Pi,max) available to animals during intense levels of locomotor activity. The maximum cardiac output of birds and mammals is calculated to scale with respect to Mh (g) as 213 Mh0.88+-0.04 (ml min-1), while aerobic Pi,max is estimated to scale approximately as 11 Mh0.88+-0.09 (W). In general, estimated inter-species aerobic Pi,max, based on Mh for all bird species (excluding hummingbirds), is calculated to scale with respect to body mass (Mb in kg) as 81 Mb0.82+-0.11 (W). Comparison of family means for Mh indicate that there is considerable diversity in aerobic capacity among birds and mammals, for example, among the medium to large species of birds the Tinamidae have the smallest relative Mh (0.25 per cent) while the Otidae have unusually large relative Mh (1.6 per cent). Hummingbirds have extremely large relative Mh (2.28 per cent), but exhibit significant sexual dimorphism in their scaling of Mh and flight muscle mass, so that when considering hummingbird flight performance it may be useful to control for sexual differences in morphology. The estimated scaling of aerobic Pi,max (based on Mh and Mb in g) for male and female hummingbirds is 0.51 Mb0.83 +/-0.07 and 0.44 Mb0.85+- 0.11 (W), respectively. Locomotory muscles are dynamic structures and it might be anticipated that where additional energetic 'costs' occur seasonally (e.g. due to migratory fattening or the development of large secondary sexual

  6. Scanner-based image quality measurement system for automated analysis of EP output

    NASA Astrophysics Data System (ADS)

    Kipman, Yair; Mehta, Prashant; Johnson, Kate

    2003-12-01

    Inspection of electrophotographic print cartridge quality and compatibility requires analysis of hundreds of pages on a wide population of printers and copiers. Although print quality inspection is often achieved through the use of anchor prints and densitometry, more comprehensive analysis and quantitative data is desired for performance tracking, benchmarking and failure mode analysis. Image quality measurement systems range in price and performance, image capture paths and levels of automation. In order to address the requirements of a specific application, careful consideration was made to print volume, budgetary limits, and the scope of the desired image quality measurements. A flatbed scanner-based image quality measurement system was selected to support high throughput, maximal automation, and sufficient flexibility for both measurement methods and image sampling rates. Using an automatic document feeder (ADF) for sample management, a half ream of prints can be measured automatically without operator intervention. The system includes optical character recognition (OCR) for automatic determination of target type for measurement suite selection. This capability also enables measurement of mixed stacks of targets since each sample is identified prior to measurement. In addition, OCR is used to read toner ID, machine ID, print count, and other pertinent information regarding the printing conditions and environment. This data is saved to a data file along with the measurement results for complete test documentation. Measurement methods were developed to replace current methods of visual inspection and densitometry. The features that were being analyzed visually could be addressed via standard measurement algorithms. Measurement of density proved to be less simple since the scanner is not a densitometer and anything short of an excellent estimation would be meaningless. In order to address the measurement of density, a transfer curve was built to translate the

  7. Acoustic output measured by thermal and mechanical indices during fetal echocardiography at the time of the first trimester scan.

    PubMed

    Nemescu, Dragos; Berescu, Anca

    2015-01-01

    We measured acoustic output, expressed as the thermal index (TI) and mechanical index (MI), during fetal echocardiography at the time of the first trimester scan. TI and MI were retrieved from the saved displays during gray-mode, high-definition color flow Doppler and pulsed-wave Doppler (tricuspid flow) ultrasound examinations of the fetal heart and from the ductus venosus assessment. A total of 399 fetal cardiac examinations were evaluated. There was a significant increase in TI values from B-mode studies (0.07 ± 0.04 [mean ± SD]) to color flow mapping (0.2 ± 0.0) and pulsed-wave Doppler studies (0.36 ± 0.05). The TI from ductus venosus assessment (0.1 ± 0.01) was significantly lower than those from Doppler examinations of the heart. MI values from B-mode scans (0.65 ± 0.12) and color flow mapping (0.71 ± 0.11) were comparable, although different, and both values were higher than those from pulsed-wave Doppler tricuspid evaluation (0.39 ± 0.03). There were no differences in MI values from power Doppler assessment between the tricuspid flow and ductus venosus. Safety indices were remarkably stable and were largely constant, especially for color Doppler (TI), tricuspid flow (MI) and ductus venosus assessment (TI, MI). We acquired satisfactory Doppler images and/or signals at acoustic levels that were lower than the actual recommendations and never reached a TI of 0.5. PMID:25438839

  8. Direct Measurements of Hydrothermal Heat Output at Juan de Fuca Ridge

    NASA Astrophysics Data System (ADS)

    Germanovich, L. N.; di Iorio, D.; Genc, G.; Hurt, R. S.; Lowell, R. P.; Holden, J. F.; Butterfield, D. A.; Olson, E. J.

    2009-12-01

    Heat output and fluid flow are key parameters for characterizing seafloor hydrothermal systems at oceanic spreading centers. In particular, they are essential for examining partition of heat and geochemical fluxes between discrete and diffuse flow components. Hydrothermal heat output also constrains permeability of young oceanic crust and thickness of the conductive boundary layer separating hydrothermal circulation from the underlying magmatic heat source. Over the past several years, we have deployed a number of relatively simple devices to make direct measurements of focused and diffuse flow. Most recently, we have used cup anemometer and turbine flow meters to measure fluid flow and heat flux at individual high-temperature vents and diffuse flow sites. The turbine flow meter (Figure 1) includes a titanium rotor assembly housed within a stainless steel tube and supported by sapphire bearings. The device can be used at different seafloor settings for measurements of both diffuse and focused flow. The spin of the rotor blades is videotaped to acquire the angular velocity, which is a function of the flow rate determined through calibration. We report data obtained during four cruises to the Main Endeavor and High Rise vent fields, Juan de Fuca Ridge (JdFR), between 2007 and 2009. Overall more than 50 successful measurements of heat flow have been made on a variety of high-, medium-, and low-temperature hydrothermal sites on the Endeavor, Mothra, and High Rise structures. For example, the velocity of diffuse flow at Endeavor ranged from ~1 to ~10 cm/sec. The flow velocity from black smokers varied from ~10 cm/sec to ~1 m/sec, which appears to be similar to EPR 9°N. Typical measurements of heat flux obtained at JdFR ranged from ~1 kW for diffuse flow to ~1 MW for black smokers. Although it is difficult to extrapolate the data and obtain the integrated heat output for a vent field on JdFR, the data are used to characterize the heat fluxes from individual vent

  9. Measurement of Trailing Edge Noise Using Directional Array and Coherent Output Power Methods

    NASA Technical Reports Server (NTRS)

    Hutcheson, Florence V.; Brooks, Thomas F.

    2002-01-01

    The use of a directional (or phased) array of microphones for the measurement of trailing edge (TE) noise is described and tested. The capabilities of this method arc evaluated via measurements of TE noise from a NACA 63-215 airfoil model and from a cylindrical rod. This TE noise measurement approach is compared to one that is based on thc cross spectral analysis of output signals from a pair of microphones placed on opposite sides of an airframe model (COP method). Advantages and limitations of both methods arc examined. It is shown that the microphone array can accurately measures TE noise and captures its two-dimensional characteristic over a large frequency range for any TE configuration as long as noise contamination from extraneous sources is within bounds. The COP method is shown to also accurately measure TE noise but over a more limited frequency range that narrows for increased TE thickness. Finally, the applicability and generality of an airfoil self-noise prediction method was evaluated via comparison to the experimental data obtained using the COP and array measurement methods. The predicted and experimental results are shown to agree over large frequency ranges.

  10. Measurement Of Trailing Edge Noise using Directional Array and Coherent Output Power Methods

    NASA Technical Reports Server (NTRS)

    Hutcheson, Florence V.; Brooks, Thomas F.

    2002-01-01

    The use of a directional array of microphones for the measurement of trailing edge (TE) noise is described. The capabilities of this method are evaluated via measurements of TE noise from a NACA 63-215 airfoil model and from a cylindrical rod. This TE noise measurement approach is compared to one that is based on the cross spectral analysis of output signals from a pair of microphones (COP method). Advantages and limitations of both methods are examined. It is shown that the microphone array can accurately measures TE noise and captures its two-dimensional characteristic over a large frequency range for any TE configuration as long as noise contamination from extraneous sources is within bounds. The COP method is shown to also accurately measure TE noise but over a more limited frequency range that narrows for increased TE thickness. Finally, the applicability and generality of an airfoil self-noise prediction method was evaluated via comparison to the experimental data obtained using the COP and array measurement methods. The predicted and experimental results are shown to agree over large frequency ranges.

  11. Increased cardiac output, not pulmonary artery systolic pressure, increases intrapulmonary shunt in healthy humans breathing room air and 40% O2

    PubMed Central

    Elliott, Jonathan E; Duke, Joseph W; Hawn, Jerold A; Halliwill, John R; Lovering, Andrew T

    2014-01-01

    Blood flow through intrapulmonary arteriovenous anastomoses (IPAVAs) has been demonstrated to increase in healthy humans during a variety of conditions; however, whether or not this blood flow represents a source of venous admixture (/) that impairs pulmonary gas exchange efficiency (i.e. increases the alveolar-to-arterial difference (A–aDO2)) remains controversial and unknown. We hypothesized that blood flow through IPAVAs does provide a source of /. To test this, blood flow through IPAVAs was increased in healthy humans at rest breathing room air and 40% O2: (1) during intravenous adrenaline (epinephrine) infusion at 320 ng kg−1 min−1 (320 ADR), and (2) with vagal blockade (2 mg atropine), before and during intravenous adrenaline infusion at 80 ng kg−1 min−1 (ATR + 80 ADR). When breathing room air the A–aDO2 increased by 6 ± 2 mmHg during 320 ADR and by 5 ± 2 mmHg during ATR + 80 ADR, and the change in calculated / was +2% in both conditions. When breathing 40% O2, which minimizes contributions from diffusion limitation and alveolar ventilation-to-perfusion inequality, the A–aDO2 increased by 12 ± 7 mmHg during 320 ADR, and by 9 ± 6 mmHg during ATR + 80 ADR, and the change in calculated / was +2% in both conditions. During 320 ADR cardiac output () and pulmonary artery systolic pressure (PASP) were significantly increased; however, during ATR + 80 ADR only was significantly increased, yet blood flow through IPAVAs as detected with saline contrast echocardiography was not different between conditions. Accordingly, we suggest that blood flow through IPAVAs provides a source of intrapulmonary shunt, and is mediated primarily by increases in rather than PASP. PMID:25085889

  12. Output tracking control for a velocity-sensorless VTOL aircraft with measurement delays

    NASA Astrophysics Data System (ADS)

    Su, Shanwei; Lin, Yan

    2015-04-01

    In this paper, we develop a non-linear controller to achieve output tracking for a velocity-sensorless vertical take-off and landing (VTOL) aircraft in the presence of measurement delays. By applying the Pade approximation technique, the original controlled system is transformed into an augmented dimension system without any time delay. After constructing full-order observers, error coordinate transformation, and system decomposition, the tracking problem of the newly transformed system is changed into the stabilisation problem of two non-minimum phase subsystems and one minimum phase subsystem. The resulting controller not only forces the VTOL aircraft to asymptotically track the desired trajectories, but also drives the unstable internal dynamics, which stands for the non-minimum property of VTOL aircraft, to follow the causal ideal internal dynamics (IID) solved via the stable system centre (SSC) method. Numerical simulation results illustrate the effectiveness of the proposed controller.

  13. Measurement and analysis of force-time outputs of pyrotechnic nuts

    NASA Technical Reports Server (NTRS)

    Neubert, V. H.

    1973-01-01

    The dynamic loadings produced by two standard pyrotechnic nuts were compared with loadings produced by four recently developed low-shock nuts. The nuts were manufactured by separate contractors. Each nut was given a number designation, the number having no special significance. The results show that the use of the Hopkinson bar to measure force-time outputs of the nuts at stud and housing sides aided greatly in understanding the events occurring in the nuts. Acceleration data appear to be dependable, for the most part, but of more limited value. The low-shock designs show considerable improvement over the standard designs above 4,000 Hz when the results are plotted in shock spectrum form. They involve some penalties with regard to weight and cost.

  14. The first measurements of hydrothermal heat output at 9°50‧N, East Pacific Rise

    NASA Astrophysics Data System (ADS)

    Ramondenc, Pierre; Germanovich, Leonid N.; Von Damm, Karen L.; Lowell, Robert P.

    2006-05-01

    Despite the importance of the heat output of seafloor hydrothermal systems for the Earth's energy budget, hydrothermal heat output measurements have been very limited. In this paper, we report the first measurements of hydrothermal heat output at the RIDGE 2000 Integrated Study Site on the East Pacific Rise. We focused our work on the Bio 9 complex, situated at 9°50'N, where there has been an extensive measurement and sampling program since 1991. This site is located along the eruptive fissure of the 1991/1992 event and the site of the 1995 earthquake swarm. We made direct measurements of advective heat output at several individual vents and at one site of diffuse flow (Tica). Although these data do not describe the complete heat flux picture at this vent field, the data yield a total hydrothermal heat output of ˜ 325 ± 160 MW with ˜ 42 ± 21 MW coming from high-temperature vents along this 2 km segment of ridge. This result assumes a diffuse flux similar to that measured at Tica occurs at each high-temperature vent site. Our initial measurements thus suggest that the heat output of the low-temperature diffuse venting is approximately 10 times that of the high-temperature vents, but may also be one or two orders of magnitude greater.

  15. A practical and theoretical definition of very small field size for radiotherapy output factor measurements

    SciTech Connect

    Charles, P. H. Crowe, S. B.; Langton, C. M.; Trapp, J. V.; Cranmer-Sargison, G.; Thwaites, D. I.; Kairn, T.; Knight, R. T.; Kenny, J.

    2014-04-15

    Purpose: This work introduces the concept of very small field size. Output factor (OPF) measurements at these field sizes require extremely careful experimental methodology including the measurement of dosimetric field size at the same time as each OPF measurement. Two quantifiable scientific definitions of the threshold of very small field size are presented. Methods: A practical definition was established by quantifying the effect that a 1 mm error in field size or detector position had on OPFs and setting acceptable uncertainties on OPF at 1%. Alternatively, for a theoretical definition of very small field size, the OPFs were separated into additional factors to investigate the specific effects of lateral electronic disequilibrium, photon scatter in the phantom, and source occlusion. The dominant effect was established and formed the basis of a theoretical definition of very small fields. Each factor was obtained using Monte Carlo simulations of a Varian iX linear accelerator for various square field sizes of side length from 4 to 100 mm, using a nominal photon energy of 6 MV. Results: According to the practical definition established in this project, field sizes ≤15 mm were considered to be very small for 6 MV beams for maximal field size uncertainties of 1 mm. If the acceptable uncertainty in the OPF was increased from 1.0% to 2.0%, or field size uncertainties are 0.5 mm, field sizes ≤12 mm were considered to be very small. Lateral electronic disequilibrium in the phantom was the dominant cause of change in OPF at very small field sizes. Thus the theoretical definition of very small field size coincided to the field size at which lateral electronic disequilibrium clearly caused a greater change in OPF than any other effects. This was found to occur at field sizes ≤12 mm. Source occlusion also caused a large change in OPF for field sizes ≤8 mm. Based on the results of this study, field sizes ≤12 mm were considered to be theoretically very small for 6

  16. In vivo dose measurement using TLDs and MOSFET dosimeters for cardiac radiosurgery.

    PubMed

    Gardner, Edward A; Sumanaweera, Thilaka S; Blanck, Oliver; Iwamura, Alyson K; Steel, James P; Dieterich, Sonja; Maguire, Patrick

    2012-01-01

    In vivo measurements were made of the dose delivered to animal models in an effort to develop a method for treating cardiac arrhythmia using radiation. This treatment would replace RF energy (currently used to create cardiac scar) with ionizing radiation. In the current study, the pulmonary vein ostia of animal models were irradiated with 6 MV X-rays in order to produce a scar that would block aberrant signals characteristic of atrial fibrillation. The CyberKnife radiosurgery system was used to deliver planned treatments of 20-35 Gy in a single fraction to four animals. The Synchrony system was used to track respiratory motion of the heart, while the contractile motion of the heart was untracked. The dose was measured on the epicardial surface near the right pulmonary vein and on the esophagus using surgically implanted TLD dosimeters, or in the coronary sinus using a MOSFET dosimeter placed using a catheter. The doses measured on the epicardium with TLDs averaged 5% less than predicted for those locations, while doses measured in the coronary sinus with the MOSFET sensor nearest the target averaged 6% less than the predicted dose. The measurements on the esophagus averaged 25% less than predicted. These results provide an indication of the accuracy with which the treatment planning methods accounted for the motion of the target, with its respiratory and cardiac components. This is the first report on the accuracy of CyberKnife dose delivery to cardiac targets. PMID:22584173

  17. Autocalibrating pulse contour analysis based on radial artery applanation tonometry for continuous non-invasive cardiac output monitoring in intensive care unit patients after major gastrointestinal surgery--a prospective method comparison study.

    PubMed

    Wagner, J Y; Langemann, M; Schön, G; Kluge, S; Reuter, D A; Saugel, B

    2016-05-01

    The T-Line(®) system (Tensys(®) Medical Inc., San Diego, CA, USA) non-invasively estimates cardiac output (CO) using autocalibrating pulse contour analysis of the radial artery applanation tonometry-derived arterial waveform. We compared T-Line CO measurements (TL-CO) with invasively obtained CO measurements using transpulmonary thermodilution (TDCO) and calibrated pulse contour analysis (PC-CO) in patients after major gastrointestinal surgery. We compared 1) TL-CO versus TD-CO and 2) TL-CO versus PC-CO in 27 patients treated in the intensive care unit (ICU) after major gastrointestinal surgery. For the assessment of TD-CO and PC-CO we used the PiCCO(®) system (Pulsion Medical Systems SE, Feldkirchen, Germany). Per patient, we compared two sets of TD-CO and 30 minutes of PC-CO measurements with the simultaneously recorded TL-CO values using Bland-Altman analysis. The mean of differences (± standard deviation; 95% limits of agreement) between TL-CO and TD-CO was -0.8 (±1.6; -4.0 to +2.3) l/minute with a percentage error of 45%. For TL-CO versus PC-CO, we observed a mean of differences of -0.4 (±1.5; -3.4 to +2.5) l/minute with a percentage error of 43%. In ICU patients after major gastrointestinal surgery, continuous non-invasive CO measurement based on autocalibrating pulse contour analysis of the radial artery applanation tonometry-derived arterial waveform (TL-CO) is feasible in a clinical study setting. However, the agreement of TL-CO with TD-CO and PC-CO observed in our study indicates that further improvements are needed before the technology can be recommended for clinical use in these patients. PMID:27246932

  18. ARX model-based damage sensitive features for structural damage localization using output-only measurements

    NASA Astrophysics Data System (ADS)

    Roy, Koushik; Bhattacharya, Bishakh; Ray-Chaudhuri, Samit

    2015-08-01

    The study proposes a set of four ARX model (autoregressive model with exogenous input) based damage sensitive features (DSFs) for structural damage detection and localization using the dynamic responses of structures, where the information regarding the input excitation may not be available. In the proposed framework, one of the output responses of a multi-degree-of-freedom system is assumed as the input and the rest are considered as the output. The features are based on ARX model coefficients, Kolmogorov-Smirnov (KS) test statistical distance, and the model residual error. At first, a mathematical formulation is provided to establish the relation between the change in ARX model coefficients and the normalized stiffness of a structure. KS test parameters are then described to show the sensitivity of statistical distance of ARX model residual error with the damage location. The efficiency of the proposed set of DSFs is evaluated by conducting numerical studies involving a shear building and a steel moment-resisting frame. To simulate the damage scenarios in these structures, stiffness degradation of different elements is considered. It is observed from this study that the proposed set of DSFs is good indicator for damage location even in the presence of damping, multiple damages, noise, and parametric uncertainties. The performance of these DSFs is compared with mode shape curvature-based approach for damage localization. An experimental study has also been conducted on a three-dimensional six-storey steel moment frame to understand the performance of these DSFs under real measurement conditions. It has been observed that the proposed set of DSFs can satisfactorily localize damage in the structure.

  19. A unique micromechanocalorimeter for simultaneous measurement of heat rate and force production of cardiac trabeculae carneae.

    PubMed

    Han, June-Chiew; Taberner, Andrew J; Kirton, Robert S; Nielsen, Poul M; Smith, Nicholas P; Loiselle, Denis S

    2009-09-01

    To study cardiac muscle energetics quantitatively, it is of paramount importance to measure, simultaneously, mechanical and thermal performance. Ideally, this should be achieved under conditions that minimize the risk of tissue anoxia, especially under high rates of energy expenditure. In vitro, this consideration necessitates the use of preparations of small radial dimensions. To that end, we have constructed a unique micromechanocalorimeter, consisting of an open-ended flow-through microcalorimeter, a force transducer, and a pair of muscle-length actuators. The device enables the metabolic and mechanical performance of cardiac trabeculae carneae to be investigated for prolonged periods in a continuously replenished oxygen- and nutrient-rich environment. PMID:19589958

  20. Testicular measurements and daily sperm output of Tori and Estonian breed stallions.

    PubMed

    Kavak, A; Lundeheim, N; Aidnik, M; Einarsson, S

    2003-06-01

    Evaluation of testicular measurements and daily sperm output (DSO) yields valuable information for predicting the reproductive capacity of stallions. The present study evaluated testicular measurements (height, length, width and circumference) and DSO of eight Tori and eight Estonian breed stallions. One ejaculate of semen was collected daily for 10 subsequent days from each stallion. The gel-free volume of semen was measured with a graduated glass cylinder and the sperm concentration was assessed with a Chorjajev chamber. The volume of gel-free fraction was multiplied by the sperm concentration to give the total number of spermatozoa (TSN). The DSO was calculated as mean TSN of collection on days 8-10 in Tori breed stallions and on days 4-10 in Estonian breed stallions. The DSO of Tori breed stallions was 12.9 x 109 spermatozoa and of Estonian breed stallions 4.5 x 109 spermatozoa (p < 0.001). Testicular measurements (in cm) 1 day after the last semen collection were as follows: left testis- height 7.3, length 10.4 and width 7.3 in Tori breed stallions, and 5.9, 8.1 and 5.9, respectively, in Estonian breed stallions; right testis- height 7.4, length 10.6 and width 7.4 in Tori breed stallions, and 5.5, 7.4 and 5.3, respectively, in Estonian breed stallions. All these testicular measurements were significantly smaller in Estonian than in Tori breed stallions (p < 0.001). Testicular circumference was 45.4 and 35.4 cm in Tori and Estonian breed stallions, respectively (p < 0.001). The testicular circumference was correlated with DSO in both Estonian (p < 0.05) and Tori breed stallions (p = 0.071). The results give us valuable information on the reproductive capacity of Tori and Estonian breed stallions. PMID:12753547

  1. Factors for successful weaning from a percutaneous cardiopulmonary support system (PCPS) in patients with low cardiac output syndrome after cardiovascular surgery.

    PubMed

    Oshima, Kiyohiro; Kunimoto, Fumio; Takahashi, Toru; Mohara, Jun; Takeyoshi, Izumi; Hinohara, Hiroshi; Hayashi, Yoshiro; Tajima, Yukio; Kuwano, Hiroyuki

    2007-11-01

    The objective of this study was to analyze the early predictive factors for successful weaning from a percutaneous cardiopulmonary support system (PCPS) in patients with low cardiac output syndrome after cardiovascular surgery. A total of 938 patients underwent cardiovascular surgery with cardiopulmonary bypass (CPB) from January 1991 to September 2006 at Gunma University Hospital. Of these 938 patients, 13 (1.4%) required PCPS to maintain hemodynamics within 48 hours after surgery. The mean age of the 13 patients was 66 years (range, 45 to 86 years). Nine patients underwent open-heart surgery, 3 repair of a thoracic aortic aneurysm, and 1 a pericardiectomy. The patients were divided into 2 groups; group A (n = 4) who were removed from PCPS and group B (n = 9) who were not removed from PCPS. The conditions during the operation and after PCPS support were compared between the 2 groups. The mean age was higher, and operation time, CPB time, and aortic cross-clamping time were significantly (P < 0.05) longer in patients with PCPS than in those without PCPS. The mean PCPS time in all 13 patients was 190 +/- 122 hours. The mean age was higher, and CPB time and the aortic cross-clamping time were longer in group B than in group A (NS). The mean duration of PCPS support was significantly (P < 0.05) shorter in group A than in group B (117 +/- 42 hours versus 235 +/- 136 hours). PCPS flow in group A could be reduced from 48 hours after PCPS induction. However, PCPC flow in group B could not be reduced, and there were significant (P < 0.05) differences in PCPS flow at 72 and 96 hours after starting PCPS. Significant (P < 0.05) differences in the absolute values of the APACHE II score, serum lactate levels, administered epinephrine dose, and levels of total bilirubin (T-Bil), serum creatinine (sCr), and lactate dehydrogenase (LDH) were found between the 2 groups within 96 hours after PCPS induction. In addition, there were significant (P < 0.05) differences in the rate of

  2. Parametric shape representation by a deformable NURBS model for cardiac functional measurements.

    PubMed

    Chen, Sheng Yong; Guan, Qiu

    2011-03-01

    This paper proposes a method of parametric representation and functional measurement of 3-D cardiac shapes in a deformable nonuniform rational B-splines (NURBS) model. This representation makes it very easy to automatically evaluate the functional parameters and myocardial kinetics of the heart, since quantitative analysis can be followed in a simple way. In the model, local deformation and motion on the cardiac shape are expressed in adjustable parameters. Especially, an effective integral algorithm is used for volumetric measurement of a NURBS shape since the volume is the most basic parameter in cardiac functional analysis. This method promises the numerical computation to be very convenient, efficient, and accurate, in comparison with traditional methods. Practical experiments are carried out, and results show that the algorithm can get satisfactory measurement accuracy and efficiency. The parametric NURBS model in cylindrical coordinates is not only very suitable to fit the anatomical surfaces of a cardiac shape, but also easy for geometric transformation and nonrigid registration, and able to represent local dynamics and kinetics, and thus, can easily be applied for quantitative and functional analysis of the heart. PMID:20952325

  3. Assessment and Utility of Frailty Measures in Critical Illness, Cardiology, and Cardiac Surgery.

    PubMed

    Rajabali, Naheed; Rolfson, Darryl; Bagshaw, Sean M

    2016-09-01

    Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement. Frailty is common among patients admitted to the intensive care unit and correlates with an increased risk for adverse events, increased resource use, and less favourable patient-centred outcomes. Analogous findings have been described across selected acute cardiology and cardiac surgical settings, in particular those that commonly intersect with critical care services. The optimal methods for screening and diagnosing frailty across these settings remains an active area of investigation. Routine assessment for frailty conceivably has numerous purported benefits for patients, families, health care providers, and health administrators through better informed decision-making regarding treatments or goals of care, prognosis for survival, expectations for recovery, risk of complications, and expected resource use. In this review, we discuss the measurement of frailty and its utility in patients with critical illness and in cardiology and cardiac surgery settings. PMID:27476983

  4. An innovative approach to evaluate a cardiac function based on surface measurement.

    PubMed

    Uematsu, M; Shiraishi, Y; Sekine, K; Yambe, T; Saijo, Y; Park, Y; Ando, H; Matsumoto, T; Takeda, S; Iwasaki, K; Umezu, M

    2005-01-01

    Major function of the heart is to pump blood flow up to all tissues or organs in the body, and it is generally recognized that cardiac function under various diseased conditions are mainly represented by a relationship between blood flow and pressure inside of the heart. In this report, an original proposal of evaluation method on cardiac function is introduced through a simultaneous measurement of various points of cardiac muscular surface. An optical three-dimensional location sensor was employed to measure a displacement change of anatomically specific points on heart surface. Then, changes in strain in each regional surface area were quantitatively obtained. This result indicated similar tendency obtained from echocardiogram. It was also indicated that there was a difference in displacements and phrases between control and arrhythmia. Moreover, strain change in regional area was coincident with a contraction of natural heart. It was found that an attempt to superimpose the data of strain change onto the video images of natural heart was extremely helpful to understand a cardiac function visually. PMID:17282050

  5. Measuring Age-Dependent Myocardial Stiffness across the Cardiac Cycle using MR Elastography: A Reproducibility Study

    PubMed Central

    Wassenaar, Peter A; Eleswarpu, Chethanya N; Schroeder, Samuel A; Mo, Xiaokui; Raterman, Brian D; White, Richard D; Kolipaka, Arunark

    2015-01-01

    Purpose To assess reproducibility in measuring left ventricular (LV) myocardial stiffness in volunteers throughout the cardiac cycle using magnetic resonance elastography (MRE) and to determine its correlation with age. Methods Cardiac MRE (CMRE) was performed on 29 normal volunteers, with ages ranging from 21 to 73 years. For assessing reproducibility of CMRE-derived stiffness measurements, scans were repeated per volunteer. Wave images were acquired throughout the LV myocardium, and were analyzed to obtain mean stiffness during the cardiac cycle. CMRE-derived stiffness values were correlated to age. Results Concordance correlation coefficient revealed good inter-scan agreement with rc of 0.77, with p-value<0.0001. Significantly higher myocardial stiffness was observed during end-systole (ES) compared to end-diastole (ED) across all subjects. Additionally, increased deviation between ES and ED stiffness was observed with increased age. Conclusion CMRE-derived stiffness is reproducible, with myocardial stiffness changing cyclically across the cardiac cycle. Stiffness is significantly higher during ES compared to ED. With age, ES myocardial stiffness increases more than ED, giving rise to an increased deviation between the two. PMID:26010456

  6. The Measurement of Maximal (Anaerobic) Power Output on a Cycle Ergometer: A Critical Review

    PubMed Central

    Driss, Tarak; Vandewalle, Henry

    2013-01-01

    The interests and limits of the different methods and protocols of maximal (anaerobic) power (Pmax) assessment are reviewed: single all-out tests versus force-velocity tests, isokinetic ergometers versus friction-loaded ergometers, measure of Pmax during the acceleration phase or at peak velocity. The effects of training, athletic practice, diet and pharmacological substances upon the production of maximal mechanical power are not discussed in this review mainly focused on the technical (ergometer, crank length, toe clips), methodological (protocols) and biological factors (muscle volume, muscle fiber type, age, gender, growth, temperature, chronobiology and fatigue) limiting Pmax in cycling. Although the validity of the Wingate test is questionable, a large part of the review is dedicated to this test which is currently the all-out cycling test the most often used. The biomechanical characteristics specific of maximal and high speed cycling, the bioenergetics of the all-out cycling exercises and the influence of biochemical factors (acidosis and alkalosis, phosphate ions…) are recalled at the beginning of the paper. The basic knowledge concerning the consequences of the force-velocity relationship upon power output, the biomechanics of sub-maximal cycling exercises and the study on the force-velocity relationship in cycling by Dickinson in 1928 are presented in Appendices. PMID:24073413

  7. Spectral contaminant identifier for off-axis integrated cavity output spectroscopy measurements of liquid water isotopes

    SciTech Connect

    Brian Leen, J.; Berman, Elena S. F.; Gupta, Manish; Liebson, Lindsay

    2012-04-15

    Developments in cavity-enhanced absorption spectrometry have made it possible to measure water isotopes using faster, more cost-effective field-deployable instrumentation. Several groups have attempted to extend this technology to measure water extracted from plants and found that other extracted organics absorb light at frequencies similar to that absorbed by the water isotopomers, leading to {delta}{sup 2}H and {delta}{sup 18}O measurement errors ({Delta}{delta}{sup 2}H and {Delta}{delta}{sup 18}O). In this note, the off-axis integrated cavity output spectroscopy (ICOS) spectra of stable isotopes in liquid water is analyzed to determine the presence of interfering absorbers that lead to erroneous isotope measurements. The baseline offset of the spectra is used to calculate a broadband spectral metric, m{sub BB}, and the mean subtracted fit residuals in two regions of interest are used to determine a narrowband metric, m{sub NB}. These metrics are used to correct for {Delta}{delta}{sup 2}H and {Delta}{delta}{sup 18}O. The method was tested on 14 instruments and {Delta}{delta}{sup 18}O was found to scale linearly with contaminant concentration for both narrowband (e.g., methanol) and broadband (e.g., ethanol) absorbers, while {Delta}{delta}{sup 2}H scaled linearly with narrowband and as a polynomial with broadband absorbers. Additionally, the isotope errors scaled logarithmically with m{sub NB}. Using the isotope error versus m{sub NB} and m{sub BB} curves, {Delta}{delta}{sup 2}H and {Delta}{delta}{sup 18}O resulting from methanol contamination were corrected to a maximum mean absolute error of 0.93 per mille and 0.25 per mille respectively, while {Delta}{delta}{sup 2}H and {Delta}{delta}{sup 18}O from ethanol contamination were corrected to a maximum mean absolute error of 1.22 per mille and 0.22 per mille . Large variation between instruments indicates that the sensitivities must be calibrated for each individual isotope analyzer. These results suggest that the

  8. Spectral contaminant identifier for off-axis integrated cavity output spectroscopy measurements of liquid water isotopes.

    PubMed

    Brian Leen, J; Berman, Elena S F; Liebson, Lindsay; Gupta, Manish

    2012-04-01

    Developments in cavity-enhanced absorption spectrometry have made it possible to measure water isotopes using faster, more cost-effective field-deployable instrumentation. Several groups have attempted to extend this technology to measure water extracted from plants and found that other extracted organics absorb light at frequencies similar to that absorbed by the water isotopomers, leading to δ(2)H and δ(18)O measurement errors (Δδ(2)H and Δδ(18)O). In this note, the off-axis integrated cavity output spectroscopy (ICOS) spectra of stable isotopes in liquid water is analyzed to determine the presence of interfering absorbers that lead to erroneous isotope measurements. The baseline offset of the spectra is used to calculate a broadband spectral metric, m(BB), and the mean subtracted fit residuals in two regions of interest are used to determine a narrowband metric, m(NB). These metrics are used to correct for Δδ(2)H and Δδ(18)O. The method was tested on 14 instruments and Δδ(18)O was found to scale linearly with contaminant concentration for both narrowband (e.g., methanol) and broadband (e.g., ethanol) absorbers, while Δδ(2)H scaled linearly with narrowband and as a polynomial with broadband absorbers. Additionally, the isotope errors scaled logarithmically with m(NB). Using the isotope error versus m(NB) and m(BB) curves, Δδ(2)H and Δδ(18)O resulting from methanol contamination were corrected to a maximum mean absolute error of 0.93 [per thousand] and 0.25 [per thousand] respectively, while Δδ(2)H and Δδ(18)O from ethanol contamination were corrected to a maximum mean absolute error of 1.22 [per thousand] and 0.22 [per thousand]. Large variation between instruments indicates that the sensitivities must be calibrated for each individual isotope analyzer. These results suggest that the properly calibrated interference metrics can be used to correct for polluted samples and extend off-axis ICOS measurements of liquid water to include plant

  9. Spectral contaminant identifier for off-axis integrated cavity output spectroscopy measurements of liquid water isotopes

    NASA Astrophysics Data System (ADS)

    Brian Leen, J.; Berman, Elena S. F.; Liebson, Lindsay; Gupta, Manish

    2012-04-01

    Developments in cavity-enhanced absorption spectrometry have made it possible to measure water isotopes using faster, more cost-effective field-deployable instrumentation. Several groups have attempted to extend this technology to measure water extracted from plants and found that other extracted organics absorb light at frequencies similar to that absorbed by the water isotopomers, leading to δ2H and δ18O measurement errors (Δδ2H and Δδ18O). In this note, the off-axis integrated cavity output spectroscopy (ICOS) spectra of stable isotopes in liquid water is analyzed to determine the presence of interfering absorbers that lead to erroneous isotope measurements. The baseline offset of the spectra is used to calculate a broadband spectral metric, mBB, and the mean subtracted fit residuals in two regions of interest are used to determine a narrowband metric, mNB. These metrics are used to correct for Δδ2H and Δδ18O. The method was tested on 14 instruments and Δδ18O was found to scale linearly with contaminant concentration for both narrowband (e.g., methanol) and broadband (e.g., ethanol) absorbers, while Δδ2H scaled linearly with narrowband and as a polynomial with broadband absorbers. Additionally, the isotope errors scaled logarithmically with mNB. Using the isotope error versus mNB and mBB curves, Δδ2H and Δδ18O resulting from methanol contamination were corrected to a maximum mean absolute error of 0.93 ‰ and 0.25 ‰ respectively, while Δδ2H and Δδ18O from ethanol contamination were corrected to a maximum mean absolute error of 1.22 ‰ and 0.22 ‰. Large variation between instruments indicates that the sensitivities must be calibrated for each individual isotope analyzer. These results suggest that the properly calibrated interference metrics can be used to correct for polluted samples and extend off-axis ICOS measurements of liquid water to include plant waters, soil extracts, wastewater, and alcoholic beverages. The general technique

  10. First measurement of the volcanic gas output from Anak Krakatau, Indonesia

    NASA Astrophysics Data System (ADS)

    Bani, Philipson; Normier, Adrien; Bacri, Clémentine; Allard, Patrick; Gunawan, Hendra; Hendrasto, Muhammad; Surono; Tsanev, Vitchko

    2015-09-01

    Anak Krakatau is the active cone that has built up in the caldera of Krakatau volcano after the 1883 cataclysmic eruption, in the Sunda Strait. Initially submarine, this new cone definitely emerged from the sea in 1930 and since then has progressively grown up through both explosive and effusive eruptions (~ one eruption every 3 years). Here we report on the first quantification of volcanic gas output from Anak Krakatau, based on airborn UV measurements of the SO2 flux in 2014, and then discuss its implication in terms of magma degassing budget since 1930. We find that during non-eruptive activity Anak Krakatau passively emits 190 ± 40 tons per day of SO2, which is comparable to the emission rate during lava dome extrusion at Merapi, central Java, but substantially more than those measured on few other Indonesian volcanoes (Tangkubanparahu, Slamet, Bromo and Papandayan). Anak Krakatau thus appears to be an important persistent emitter of volcanic volatiles in the Indonesian arc, even though this very active region still remains weakly documented on that aspect. Combining with available data for the composition of its high-temperature (~ 700 °C) crater gases, Anak Krakatau may release annually 0.07 Tg of SO2, 3 Tg of H2O, and 0.13 moles of 3He. Using published data for the sulfur content of its feeding magma, we estimate that about 1.3 km3 of magma may have been degassed during its subaerial growth over the past 85 years. The subaerial cone represents only 14% of this volume. Thus, a substantial fraction (1.1 km3) of the degassed magma did not extrude and may have accumulated in the plumbing system. This inference is consistent with geophysical and petrologic evidence of the presence of dense magma bodies in the shallow crustal basement of Krakatau volcano.