Time and Concentration Components of Indicator-Dilution Curves Recorded Following Central Injections of Dye in Normal Human Subjects

Carter, Stefan A.; Swan, H. J. C.; Wood, Earl H.

doi:10.1161/01.cir.19.3.430

Cited by 16 publications

(8 citation statements)

References 10 publications

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“…Both groups used slug injections of dye and a single sampling site; a method, which was shown by Lange et al (1966) to prolong the MTT-T D difference by some 6 s due to dispersion of the dye signal at the site of injection without affecting the MTT value. This would explain why there is a good agreement between the MTT values of Carter et al (1959) and the resting MTT values of the present investigation (19.5 and 18.2 s, respectively), while values for the MTT T D difference deviate.…”

Section: Blood Flow and Circulatory Transfer During Rest And Exercisesupporting

confidence: 69%

“…However, Carter et al (1959) have measured the pulmonary-artery to radial-artery MTT in healthy supine adults at rest and found it to be 19.5 s, while T D was 11.7 s. Grace et al (1957) report a right heart-to-radial artery T D of 10.7 s in resting subjects. Both groups used slug injections of dye and a single sampling site; a method, which was shown by Lange et al (1966) to prolong the MTT-T D difference by some 6 s due to dispersion of the dye signal at the site of injection without affecting the MTT value.…”

Section: Blood Flow and Circulatory Transfer During Rest And Exercisementioning

confidence: 99%

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Time components of circulatory transport from the lungs to a peripheral artery in humans

et al. 2006

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Blood gas changes occurring in the lung undergo delay and damping on their way to a peripheral artery sampling site. Knowledge of the time components of circulatory transfer is important for the understanding of respiratory control and cardiovascular reflexes in response to blood gas transients. Providing steady state with regard to VA/Q distribution, cardiac output and peripheral blood flow, the relationship between the time courses of small end-tidal and peripheral PO2 changes is determined by the transfer function of the interposed vascular segment. This transfer function, expressed as delay time TD and mean transit time (MTT), was measured in six well-trained subjects, allowing the calculation of arterial time-courses from end-tidal to the reverse. They were studied at rest and during four different dynamic leg exercise intensities in the supine posture. TD and MTT amounted to 15.8 +/- 1.7 (mean +/- SEM) and 18.3 +/- 2.1 s at rest and were shortened to 7.7 +/- 0.6 and 11.5 +/- 1.8 s during exercise at 170 W. The shortening of TD and MTT did not appear to be simply an inverse function of cardiac output, suggesting that the shortening occurs in the central circulatory segment but not in the arm segment.

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Section: Blood Flow and Circulatory Transfer During Rest And Exercisesupporting

confidence: 69%

Section: Blood Flow and Circulatory Transfer During Rest And Exercisementioning

confidence: 99%

Time components of circulatory transport from the lungs to a peripheral artery in humans

et al. 2006

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“…Normally from the right atrium to the ear the time is approximately 10 sec. (Carter et al, 1959). It varies with the length of passage of the dye, the volume of fluid through which it flows, and the cardiac output.…”

Section: Methodsmentioning

confidence: 99%

Dye Dilution Curves in Congenital Heart Disease

Cm¹,

Sh²,

Wilcken³

et al. 1960

Heart

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The need for methods capable of detecting and estimating roughly the size of congenital cardiac defects has increased with the recent rapid developments in cardiac surgery. The application of dye dilution technique to the study of these patients is largely due to the extensive work of Wood and his colleagues at the Mayo Clinic since 1950. However, although the development of these techniques represents a most valuable addition to the methods available for investigation, they are perhaps more elaborate than is possible in many smaller centres engaged in the diagnosis of congenital heart disease.Recording the passage of dye through the pinna of the transilluminated ear by a photoelectric cell and recording apparatus offers the advantage of simplicity, but has not found universal favour because of technical difficulties and lack of a suitable dye. With the development of high-stability electronic amplifiers and recorders and the introduction of Coomassie blue, we have found this method to be satisfactory for qualitative investigations. The purpose of our paper is to describe the results of this method used at the time of right heart catheterization in a series of patients with congenital heart disease, and to assess its value in clinical practice. MATERIAL AND METHODSSixty-eight unselected patients with suspected congenital heart disease were studied at rest by means of right heart catheterization ( Table I). Pressures were recorded by electromanometers and direct writing recorder. Arterial and venous blood samples were estimated for oxygen saturation by a modification of Gatman's spectrophotometric technique (Wade et al., 1953) or, if the samples had been taken after injecting dye, they were estimated by the Haldane method. The ear oximeter was based on the design of Wood and Geraci (1949) and has been used in previous work from this laboratory (Korner and Shillingford, 1955;Taylor and Shillingford, 1959).The success of the technique depends to a large extent on the recording apparatus and the design of this has presented considerable difficulty owing to the very small changes in current in the photo-electric cell during the passage of the blue dye through the ear. We have used the Cambridge earpiece and chopper amplifier, feeding either into an Evershed and Vignole 0-1 m.a. recorder or a Cambridge recorder (Fig. 1). This combination gives the high amplification and stability necessary for this method of recording. Amplifiers and recorders used in electrocardiographic or pressure recording systems have proved quite unsuitable.The sensitivity of the amplification system was arranged to give a maximum deflection of 5-7 cm. at the peak of the dilution curve, the sensitivity chosen being the highest at which a stable base line could be obtained with the patient breathing room air. After recording pressures from a chamber of the heart, blood samples were taken for determination of blood oxygen saturation and the dye was then immediately injected as rapidly as possible. The site of the injection was checked by screeni...

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“…Most of these have been discussed in the prior sections of this symposium and will not be touched on further here; they are, however, undoubtedly responsible for the relatively wide range of values for the various components of arterial dilution curves recorded from normal subjects. 38 In addition to these more or less nonspecific factors in the circulation that affect the contour of dilution curves, it would be expected that any abnormal communication in the circulatory system that significantly decreases or increases the transit time of a portion of the blood traversing the central circulation would produce specific effects on the contour of the dilution curve. Such abnormal communications, that is, intracardiac or great-vessel defects, are usually the result of congenital heart disease and are usually associated with abnormal circulatory shunts either in the right-to-left or the left-to-right direction.…”

Section: Figurementioning

confidence: 99%

Diagnostic Applications of Indicator-Dilution Technics In Congenital Heart Disease

Wood

1962

Circulation Research

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In summarizing the diagnostic value of the indicator-dilution technics in the study and investigation of congenital heart disease, perhaps a simple listing of the advantages and disadvantages of the technics will suffice. The advantages are as follows: 1. The technics have a high degree of safety. In the more than 3000 cardiac patients in whom they have been utilized there have been no deaths and little or no morbidity. 2. The sensitivity of the technics for the detection and localization of right-to-left and left-to-right shunts is much superior to that of the conventional blood-gas methods. 3. Quantitative determinations of systemic and pulmonary blood flow and intrathoracic shunts by indicator-dilution methods can be made simultaneously over periods of less than 1 minute; when indicator dyes are used, these technics do not require manometrie analyses, accessory respiratory exchange studies, or active cooperation of the patient; and they are independent of foreign (anesthetic) gases in the blood. 4. The technics are versatile and can be extremely useful either for the detection and diagnosis of minimal, relatively simple defects or for the elucidation of the extremely complex types of congenital malformations. 5. The information obtained is of both a qualitative and a quantitative nature; that is, the nature and location of defects can be determined and, in addition, the magnitude and direction of flow through the defects in question as well as the levels of systemic and pulmonary blood flows can be estimated. The disadvantages of the technics are as follows: 1. Rather complicated and sensitive recording equipment is essential. 2. Considerable technical skill is required of the persons carrying out the procedure in the placement of the necessary needles and catheters and in the proper selection of the multiple possible injection and sampling sites reached by these instruments in order to obtain the information needed to establish the diagnosis in question. 3. Correct interpretation of the diagnostic significance of the dilution curves obtained requires careful study and considerable experience by the person responsible for this phase of the investigation. In other words, these technics entail relatively little discomfort and little danger for the patient, but require good equipment and, more important, considerable time, effort and skill on the part of the investigator and his assistants in order to obtain highly successful results.

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Time and Concentration Components of Indicator-Dilution Curves Recorded Following Central Injections of Dye in Normal Human Subjects

Cited by 16 publications

References 10 publications

Time components of circulatory transport from the lungs to a peripheral artery in humans

Time components of circulatory transport from the lungs to a peripheral artery in humans

Dye Dilution Curves in Congenital Heart Disease

Diagnostic Applications of Indicator-Dilution Technics In Congenital Heart Disease

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