Comparison of Dye-Dilution and Plethysmographic Blood Flow Measurements: An Evaluation of the Influence of Invasive Techniques on Blood Flow and on Arterial and Femoral Venous Substrate Variables in Man

1990 ◽  
Vol 79 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Lennart Jorfeldt ◽  
Hans Rutberg
Keyword(s):  
Blood Flow ◽  
Strain Gauge ◽  
Venous Blood ◽  
Blood Gases ◽  
Dilution Method ◽  
Flow Measurements ◽  
Leg Blood Flow ◽  
Fick Principle ◽  
Strain Gauge Plethysmography ◽  
Dye Dilution

1. In eight healthy volunteers we compared leg blood flow, as determined in a calf segment by strain-gauge plethysmography, with the flow measured by a constant-rate infusion of Indocyanine Green dye into the femoral artery. The representativeness of the calf segment was evaluated by complementary measurements with additional strain gauges attached around the proximal and distal crural and the distal thigh segments (n = 6). Furthermore, we investigated the influence of the catheterization procedure and a simulated vascular puncture, as well as repeated venous occlusions, on blood flow and on arterial and femoral venous substrate concentrations and blood gases (n = 8). 2. The leg blood flow measured by dye dilution was 0.31 ± 0.03 litre/min (mean ± sem). The blood flow in the calf segments was 14.8 ± 1.6 ml min−1 litre−1 and no difference between the legs was observed. Extended to the whole leg the plethysmographic blood flow was 0.17 ± 0.01 litre/min and thus lower (43 ± 7%, P < 0.001) than the flow determined by the indicator-dilution method. Blood flow in the legs was not influenced by catheterization or sham punctures of the vessels or by repeated venous occlusions. 3. The concentrations of glucose, lactate and glycerol, as well as blood gas variables, in arterial and femoral venous blood did not change during the study or decreased so slightly (pH and lactate) that the arteriovenous difference was not influenced. 4. We conclude that the blood flow of the total leg cannot be satisfactorily estimated from strain-gauge plethysmography of a single calf segment. Strain-gauge plethysmography can therefore not be recommended for quantitative studies of substrate turnover in the leg tissues applying the Fick principle. Catheterization of the femoral vessels, or manipulations close to them with a thin cannula or repeated venous occlusions, has no significant effect on leg blood flow and substrate exchange.

Determination of Leg Blood Flow During Exercise in Man: An Indicator-Dilution Technique Based on Femoral Venous Dye Infusion

1973 ◽  
Vol 45 (2) ◽  
pp. 135-146 ◽  
Author(s):  
J. Wahren ◽  
L. Jorfeldt
Keyword(s):  
Blood Flow ◽  
Healthy Subjects ◽  
Femoral Vein ◽  
Indicator Dilution ◽  
Dilution Method ◽  
Dilution Technique ◽  
Flow Measurements ◽  
Leg Blood Flow ◽  
Indicator Dilution Technique

1. A dye-dilution method has been developed for the determination of leg blood flow in man. The method is based on the infusion of indicator into the distal part of the femoral vein with blood sampling from the same vein at the level of the inguinal ligament. Catheterization of the femoral artery is not required. Evidence of adequate mixing of dye and blood is presented, based on the finding of the same dye concentration in samples from two different levels in the femoral vein. 2. Leg blood flow measured by this technique at rest and during exercise in six healthy subjects was found to agree closely with simultaneous determinations with an intra-arterial indicator-dilution technique. The reproducibility of the blood-flow measurements, expressed as the coefficient of variation for a single determination, was 9·8%. 3. A routine procedure is suggested for leg blood-flow determination based on femoral venous dye infusion. Using this procedure, leg blood flow was measured in twelve healthy subjects at rest and during exercise at work loads of 100, 200, 400 and 600 kpm/min. A linear relationship was found between leg blood flow and pulmonary oxygen uptake. 4. The applicability of this method to the study of patients with occlusive arterial disease of the leg is illustrated by findings in two patients before and after vascular reconstruction.

Strain gauge plethysmography for blood flow measurements in the legs of children

1975 ◽  
Vol 3 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Wigher Mortensson ◽  
Torgil Hallb��k ◽  
Nils-Rune Lundstr�m
Keyword(s):  
Blood Flow ◽  
Strain Gauge ◽  
Flow Measurements ◽  
Strain Gauge Plethysmography ◽  
Blood Flow Measurements

scholarly journals The beginnings of cardiac catheterization and the resulting impact on pulmonary medicine

2017 ◽  
Vol 313 (4) ◽  
pp. L651-L658 ◽  
Author(s):  
John B. West
Keyword(s):  
Blood Flow ◽  
Cardiac Catheterization ◽  
Nobel Prize ◽  
Venous Blood ◽  
Interventional Cardiology ◽  
Primary Objective ◽  
Mixed Venous Blood ◽  
Pulmonary Medicine ◽  
Fick Principle ◽  
The Right

The early history of cardiac catheterization has many interesting features. First, although it would be natural to assume that the procedure was initiated by cardiologists, two of the three people who shared the Nobel Prize for the discovery were pulmonologists, while the third was a urologist. The primary objective of the pulmonologists André Cournand and Dickinson Richards was to obtain mixed venous blood from the right heart so that they could use the Fick principle to calculate total pulmonary blood flow. Cournand’s initial catheterization studies were prompted by his reading of an account by Werner Forssmann, who catheterized himself 12 years before. His bold experiment was one of the most bizarre in medical history. In the earliest studies that followed, Cournand and colleagues first passed catheters into the right atrium, and then into the right ventricle, and finally, the pulmonary artery. At the time, the investigators did not appreciate the significance of the low vascular pressures, nor that what they had done would revolutionize interventional cardiology. Within a year, William Dock predicted that there would be a very low blood flow at the top of the upright lung, and he proposed that this was the cause of the apical localization of pulmonary tuberculosis. The fact that the pulmonary vascular pressures are very low has many implications in lung disease. Cardiac catheterization changed the face of investigative cardiology, and its instigators were awarded the Nobel Prize in 1956.

scholarly journals The Contribution of Arterial Blood Gases in Cerebral Blood Flow Regulation and Fuel Utilization in Man at High Altitude

2015 ◽  
Vol 35 (5) ◽  
pp. 873-881 ◽  
Author(s):  
Christopher K Willie ◽  
David B MacLeod ◽  
Kurt J Smith ◽  
Nia C Lewis ◽  
Glen E Foster ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
High Altitude ◽  
Cerebral Metabolism ◽  
Venous Blood ◽  
Blood Gases ◽  
Cerebrovascular Reactivity ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Cerebrovascular Function

The effects of partial acclimatization to high altitude (HA; 5,050 m) on cerebral metabolism and cerebrovascular function have not been characterized. We hypothesized (1) increased cerebrovascular reactivity (CVR) at HA; and (2) that CO2 would affect cerebral metabolism more than hypoxia. PaO2 and PaCO2 were manipulated at sea level (SL) to simulate HA exposure, and at HA, SL blood gases were simulated; CVR was assessed at both altitudes. Arterial–jugular venous differences were measured to calculate cerebral metabolic rates and cerebral blood flow (CBF). We observed that (1) partial acclimatization yields a steeper CO2-H+ relation in both arterial and jugular venous blood; yet (2) CVR did not change, despite (3) mean arterial pressure (MAP)-CO2 reactivity being doubled at HA, thus indicating effective cerebral autoregulation. (4) At SL hypoxia increased CBF, and restoration of oxygen at HA reduced CBF, but neither had any effect on cerebral metabolism. Acclimatization resets the cerebrovasculature to chronic hypocapnia.

Cardiovascular adjustments to laboratory diving in beavers and nutria

1982 ◽  
Vol 242 (5) ◽  
pp. R434-R440
Author(s):  
T. McKean
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Regional Blood Flow ◽  
Castor Canadensis ◽  
Venous Blood ◽  
Regional Distribution ◽  
Blood Gases ◽  
Myocastor Coypus ◽  
Recovery From Anesthesia ◽  
Rate Of Decline

Beavers (Castor canadensis) and nutria (Myocastor coypus) were anesthetized with halothane and catheters placed in the left ventricle, aorta and pulmonary artery, right ventricle or right atrium. The animals were strapped to a board and following recovery from anesthesia the following measurements were taken: regional distribution of blood flow, cardiac output, O2 consumption, arterial and venous blood gases, and pH. The animal was then immersed in 15-20 degrees C water for up to 2.75 min (nutria) or 4 min (beaver) and the measurements repeated. Heart rate and cardiac output decreased by 80 and 75%, respectively. Arterial and venous oxygen partial pressure and content fell as did pH whereas CO2 pressures rose during diving. Oxygen consumption at rest was 124 and 102% of that predicted on the basis of body mass for the beaver and nutria, respectively. Rate of decline of O2 stores during diving decreased by 93% in beavers and 89% in nutria compared to the predive value. Regional blood flow decreased to all organs except the adrenals, heart, and lungs. Blood flow to the brain increased during diving.

Segment stroke work and metabolism depend on coronary blood flow in the pig

1978 ◽  
Vol 234 (5) ◽  
pp. H597-H607 ◽  
Author(s):  
D. F. Stowe ◽  
D. G. Mathey ◽  
W. Y. Moores ◽  
S. A. Glantz ◽  
R. M. Townsend ◽  
...  
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Myocardial Ischemia ◽  
Mechanical Performance ◽  
Venous Blood ◽  
Lactate Production ◽  
Blood Gases ◽  
Metabolic Effects ◽  
Stroke Work ◽  
Blood Flows

We determined the mechanical and metabolic effects of graded myocardial ischemia in 23 open-chest, anesthetized pigs. By connecting the midportion of the left anterior descending artery (LAD) to the carotid artery via a constant volume, calibrated pump, we reduced the flow in the LAD to 0, 25, 50, and 75% of control rates for periods of 1 h. Flows of 100% and 150% were also examined. Using pairs of ultrasonic crystals to measure segment dimensions, we calculated segment shortening and thickening, and total and systolic stroke work in the ischemic and normally perfused segments. Blood gases, pH, and lactate and inosine balances were determined from the regional coronary venous blood. At coronary blood flows of 0, 25, 50, and 75% of normal resting flow, total segment work was 8 +/- 8, 25 +/- 4, 51 +/- 5, and 80 +/- 6% of control, respectively, while systolic segment work was -2 +/- 5, -10 +/- 5, 40 +/- 5, and 86 +/- 7% of control, respectively (means +/- SE). Thus, the decrease in total segment stroke work is proportional to the decrease in flow over the range 0-100%. However, no useful work (i.e., systolic work) is done until flow exceeds 25%. Segment shortening and thickening are significantly depressed with flows diminished by only 25%. Segmental inosine production correlates with lactate production and parallels decreased mechanical performance.

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