Velocity of Blood Flow and Stroke Volume Obtained From the Pressure Pulse *

Jones, William B.; Hefner, Lloyd L.; Bancroft, William H.; Klip, Willem

doi:10.1172/jci103986

Cited by 22 publications

(6 citation statements)

References 8 publications

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“…Within the same animal this gives a reasonable index of cardiac output. A variant of this method is to measure the rate of rise of pressure within the aorta (aortic dp/dt) rather than the actual pressure rise itself (Jones, Hefner, Bancroft & Klip, 1959;Greenfield et al, 1962).…”

Section: Discussionmentioning

confidence: 99%

The effect of catecholamine infusions on myocardial blood flow, metabolic heat production and on general haemodynamics, before and after alprenolol (H56/28), in anaesthetized cats

Parratt

Wadsworth

1970

British J Pharmacology

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Summary1. In cats anaesthetized with pentobarbitone sodium, infusions of adrenaline, noradrenaline (05 ,ug/kg per min) and isoprenaline (025 ,ug/kg per min) increased myocardial blood flow, myocardial heat production, left ventricular systolic and end-diastolic pressures, left ventricular +ve and -ve dpidt max, and calculated cardiac output, effort and oxygen consumption. These effects (apart from the effect of noradrenaline on left ventricular systolic pressure) were markedly reduced by previous administration of alprenolol (05 or 1-0 mg/kg). 2. Infusions of adrenaline and noradrenaline increased arterial diastolic blood pressure and isoprenaline reduced it. After alprenolol the effects of adrenaline and noradrenaline were potentiated and that of isoprenaline abolished; in some experiments isoprenaline increased arterial diastolic pressure after alprenolol. Alprenolol did not influence the increases in arterial systolic pressure which followed the administration of adrenaline and noradrenaline. 3. Isoprenaline-induced tachycardia was markedly reduced and adrenaline tachycardia was converted to bradycardia after alprenolol. The bradycardia which occurred during noradrenaline infusions was unaffected. 4. After blockade by alprenolol, recovery of the effects of isoprenaline on left ventricular dp/dt and on heart rate occurred more quickly than recovery of the effects on arterial diastolic pressure. This suggests that alprenolol has a greater affinity for 32-than for /3-adrenoceptors. 5. Intravenous administration of acetylcholine decreased arterial blood pressure, left ventricular pressure and +ve and -ve dp/dt max. During recovery from these effects there was a marked increase in +ve dp/dt max. which was absent after the administration of alprenolol (05 mg/kg). Because this dose of alprenolol is thus able to block the effects of reflex sympathetic cardiac nerve stimulation but does not completely antagonize the effects of exogenous adrenaline on dp/dt, it is suggested that alprenolol may have some adrenergic neurone blocking activity. 6. Increases in liver and myocardial blood flow and heat production produced by noradrenaline, adrenaline and isoprenaline were reduced after alprenolol. 7. Isoprenaline reduced air-way resistance and this effect was abolished by alprenolol; increases in air-way resistance produced by adrenaline and noradrenaline were augmented. All three amines inhibited intestinal smooth

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Section: Discussionmentioning

confidence: 99%

The effect of catecholamine infusions on myocardial blood flow, metabolic heat production and on general haemodynamics, before and after alprenolol (H56/28), in anaesthetized cats

Parratt

Wadsworth

1970

British J Pharmacology

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“…By assuming that retrograde (reflected) pressure waves are negligible during systole, it is possible to estimate the pressure gradient and the forward flow from an ABP waveform. Specifically, stroke volume is proportional to the area under the systolic portion of the ABP pulse (9, 10). …”

Section: Investigational Co-from-abp Algorithmsmentioning

confidence: 99%

The cardiac output from blood pressure algorithms trial*

Sun

Reisner

Saeed³

et al. 2009

Critical Care Medicine

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Objective The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous reference CO by thermodilution measurements, collected in an intensive care unit (ICU) patient population during routine clinical operations. We employed this data set to evaluate a set of investigational algorithms, and to establish a public resource for the meaningful comparison of alternative CO-from-ABP algorithms. Design A retrospective comparative analysis of eight investigational CO-from-ABP algorithms using the Multiparameter Intelligent Monitoring in Intensive Care II database. Setting Mixed medical/surgical ICU of a university hospital. Patients A total of 120 cases. Interventions None. Measurements CO estimated by eight investigational CO-from-ABP algorithms, and COTD as a reference. Main Results All investigational methods were significantly better than mean arterial pressure (MAP) at estimating direction changes in COTD. Only the formula proposed by Liljestrand and Zander in 1928 was a significantly better quantitative estimator of COTD compared with MAP (95% limits-of-agreement with COTD: –1.76/+1.41 L/min versus –2.20/+1.82 L/min, respectively; p < 0.001, per the Kolmogorov-Smirnov test). The Liljestrand method was even more accurate when applied to the cleanest ABP waveforms. Other investigational algorithms were not significantly superior to MAP as quantitative estimators of CO. Conclusions Based on ABP data recorded during routine intensive care unit (ICU) operations, the Liljestrand and Zander method is a better estimator of COTD than MAP alone. Our attempts to fully replicate commercially-available methods were unsuccessful, and these methods could not be evaluated. However, the data set is publicly and freely available, and developers and vendors of CO-from-ABP algorithms are invited to test their methods using these data.

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“…In vivo, the estimate of ultimate measured flow is affected by the superimposed reflected pressure waves present as differences in the shape of the pressure and the flow curve, and thus might influence the accuracy of measurement (18). Presented experimental data suggest either a negligible effect of reflected waves on the stroke volume calculation in the ejection phase recorded during occluded conditions or that the energy of reflected waves is manifested in the ratio of AUC to the MaximalPeak amp (27,49).…”

Section: Discussionmentioning

confidence: 91%

Noninvasive assessment of cardiac output by brachial occlusion-cuff technique: comparison with the open-circuit acetylene washin method

Sajgalik

Kremen

Carlson

et al. 2016

Journal of Applied Physiology

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Cardiac output (CO) assessment as a basic hemodynamic parameter has been of interest in exercise physiology, cardiology, and anesthesiology. Noninvasive techniques available are technically challenging, and thus difficult to use outside of a clinical or laboratory setting. We propose a novel method of noninvasive CO assessment using a single, upper-arm cuff. The method uses the arterial pressure pulse wave signal acquired from the brachial artery during 20-s intervals of suprasystolic occlusion. This method was evaluated in a cohort of 12 healthy individuals (age, 27.7 ± 5.4 yr, 50% men) and compared with an established method for noninvasive CO assessment, the open-circuit acetylene method (OpCirc) at rest, and during low- to moderate-intensity exercise. CO increased from rest to exercise (rest, 7.4 ± 0.8 vs. 7.2 ± 0.8; low, 9.8 ± 1.8 vs. 9.9 ± 2.0; moderate, 14.1 ± 2.8 vs. 14.8 ± 3.2 l/min) as assessed by the cuff-occlusion and OpCirc techniques, respectively. The average error of experimental technique compared with OpCirc was -0.25 ± 1.02 l/min, Pearson's correlation coefficient of 0.96 (rest + exercise), and 0.21 ± 0.42 l/min with Pearson's correlation coefficient of 0.87 (rest only). Bland-Altman analysis demonstrated good agreement between methods (within 95% boundaries); the reproducibility coefficient (RPC) = 0.84 l/min with R = 0.75 at rest and RPC = 2 l/min with R = 0.92 at rest and during exercise, respectively. In comparison with an established method to quantify CO, the cuff-occlusion method provides similar measures at rest and with light to moderate exercise. Thus, we believe this method has the potential to be used as a new, noninvasive method for assessing CO during exercise.

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Velocity of Blood Flow and Stroke Volume Obtained From the Pressure Pulse *

Cited by 22 publications

References 8 publications

The effect of catecholamine infusions on myocardial blood flow, metabolic heat production and on general haemodynamics, before and after alprenolol (H56/28), in anaesthetized cats

The effect of catecholamine infusions on myocardial blood flow, metabolic heat production and on general haemodynamics, before and after alprenolol (H56/28), in anaesthetized cats

The cardiac output from blood pressure algorithms trial*

Noninvasive assessment of cardiac output by brachial occlusion-cuff technique: comparison with the open-circuit acetylene washin method

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