The effect of respiration on the monitoring of stroke volume and cardiac output by the electrical impedance technique

1976 ◽  
Vol 2 (1) ◽  
pp. 3-6 ◽  
Author(s):  
J. Endresen ◽  
D. W. Hill
1991 ◽  
Vol 71 (3) ◽  
pp. 1025-1031 ◽  
Author(s):  
R. B. Cotton ◽  
D. P. Lindstrom ◽  
H. W. Sundell ◽  
J. W. Hammon ◽  
A. Silberberg ◽  
...  

Cardiac-related deflections in thoracic electrical impedance have been thought to correlate sufficiently well with cardiac stroke volume to be used as the basis for a noninvasive estimation of cardiac output. To determine more precisely the physiological origin of the impedance deflection (DZ), we regarded right ventricular stroke volume (SVa) as the sum of two components: 1) that part of SVa responsible for the transient increment in pulmonary blood volume within a cardiac cycle, SVa-v and 2) the remaining part of SVa, (SVa-SVa-v). SVa-v was measured in lambs by integration of the difference between pulmonary arterial and pulmonary venous flow. SVa and its components were varied experimentally by opening and closing an aorticocaval shunt or by inflating and deflating a cuff implanted around the pulmonary artery. DZ was measured using a tetrapolar disk electrode system. Multivariate linear regression analysis revealed that SVa-v had a significant positive effect on DZ, and, at the same time, (SVa-SVa-v) had a significant negative effect on DZ. In the pulmonary artery occluder model, the positive effect of SVa-v dominated the opposing negative effect of (SVa - SVa-v) so that the net effect of SVa on DZ was positive and significant. In the aorticocaval shunt model, these effects opposed each other to the extent that there was no significant correlation between SVa and DZ. These results shed new light on the physiological origin of DZ. They also demonstrate that use of DZ to measure acute changes in cardiac output may yield misleading results. Changes or the lack of changes in thoracic electrical impedance do not necessarily reflect cardiac output status.


PEDIATRICS ◽  
1963 ◽  
Vol 32 (4) ◽  
pp. 660-670
Author(s):  
Jere H. Mitchell

THE mechanisms of adaptation of the left ventricle to the demands of muscular exercise have intrigued cardiovascular physiologists for many years. Although highly complex, these adaptive mechanisms are more and more susceptible to analysis and quantification. In this presentation I will attempt to identify some of the individual factors which appear to be important in the response of the left ventricle to exercise, beginning with data obtained from experiments on conscious normal male subjects and proceeding to experiments performed on dog preparations in which individual factors were controlled and analyzed. The changes in oxygen intake, cardiac output, estimated arteriovenous oxygen difference, pulse rate and estimated mean stroke volume were determined in 15 normal male subjects during rest in the standing position and during treadmill exercise at the maximal oxygen intake level. Oxygen intake was obtained from the volume and composition of expired air, cardiac output by the dye dilution technique, and pulse rate from the electrocardiogram. Estimated arteriovenous oxygen difference was obtained by dividing the oxygen intake by the cardiac output (Fick principle) and estimated mean stroke volume by dividing the cardiac output by the heart rate. The data are shown in Figure 1. Oxygen intake increased from a mean value of 0.34 at rest to a maximal value of 3.22 L./min. The corresponding mean values for cardiac output were 5.4 and 23.4 L./min. and for arteriovenous oxygen difference were 6.5 and 14.3 ml./100 ml. Thus, as oxygen intake increased 9.5 times, the cardiac output increased 4.3 times and the arterio venous oxygen difference 2.2 times.


PEDIATRICS ◽  
1985 ◽  
Vol 76 (6) ◽  
pp. 918-921
Author(s):  
Frans J. Walther ◽  
Paul Y. K. Wu ◽  
Bijan Siassi

Phototherapy is known to increase peripheral blood flow in neonates, but information on the associated cardiovascular effects is not available. Using pulsed Doppler echocardiography we evaluated cardiac output and stroke volume in 12 preterm and 13 term neonates during and after phototherapy. We concomitantly measured arterial limb blood flow by strain gauge plethysmography and skin blood flow by photoplethysmography. Cardiac output decreased by 6% due to reduced stroke volume during phototherapy, whereas total limb blood flow and skin blood flow increased by 38% and 41%, respectively. Peripheral blood flow increments tended to be higher in the preterm than in the term infants. The reduced stroke volume during phototherapy may be an expression of reduced activity of the newborn during phototherapy. For healthy neonates the reduction in cardiac output is minimal, but for sick infants with reduced cardiac output, this reduction may further aggravate the decrease in tissue perfusion.


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