Evaluation of a method for estimating cardiac output from a single breath in humans

1982 ◽  
Vol 53 (4) ◽  
pp. 1034-1038 ◽  
Author(s):  
H. Chen ◽  
N. P. Silverton ◽  
R. Hainsworth
Keyword(s):  
Cardiac Output ◽  
Normal Subjects ◽  
Random Errors ◽  
Tolerance Limits ◽  
Mean Values ◽  
Single Breath ◽  
Significant Difference ◽  
Venous Pco2 ◽  
Mixed Venous ◽  
Single Breath Method

We have modified the single-breath method of Kim et al. (J. Appl. Physiol. 21: 1338–1344, 1966) for estimating cardiac output and arterial and mixed venous carbon dioxide tensions (PCO2). We assessed this using 30 normal subjects and 23 cardiac patients. The procedure was performed satisfactorily in all but two patients. The random errors, from 60 pairs of estimates of cardiac output in normal subjects and 50 pairs in patients, were +/- 12.8 and +/- 19.6% (95% tolerance limits; i.e., coefficient of variation multiplied by 2 for n greater than 50). The systematic error was assessed in 15 patients from comparisons with results obtained by the direct Fick method. There was no significant difference except in two patients with large intracardiac shunts. Mean values of cardiac output by single-breath and direct Fick estimates were 3.80 and 3.83 l/min. Arterial and mixed venous PCO2 were estimated by the single-breath method with random errors of +/- 1.5 and +/- 1.4 Torr, respectively, and no significant systematic errors. We conclude that our modification of the single-breath method is reliable in humans at rest, although the procedures for delivering the breath and processing the data are of critical importance.

A modified single breath method for estimation of cardiac output in humans at rest and during exercise

1987 ◽  
Vol 72 (4) ◽  
pp. 437-441 ◽  
Author(s):  
Y. M. H. Al-Shamma ◽  
R. Hainsworth ◽  
N. P. Silverton
Keyword(s):  
Cardiac Output ◽  
Normal Subjects ◽  
Random Errors ◽  
O2 Uptake ◽  
Mean Values ◽  
Single Breath ◽  
Expired Gas ◽  
The Mean ◽  
Rest And Exercise ◽  
Single Breath Method

1. This study was undertaken to determine the accuracy of a modification of a single breath method for estimation of cardiac output. The technique incorporated a single rebreathing stage followed by a prolonged expiration. Cardiac output was determined from the O2 uptake and the instantaneous changes in O2 and CO2 in the expired gas during the prolonged expiration. 2. The mean values and the random errors (determined from the differences between pairs of estimates) of cardiac outputs in normal subjects at rest and exercise were 5.42 and ± 0.60 litres/min (2 sd, 60 pairs) and 14.1 and ±1.8 litres/min (40 pairs). 3. Larger random errors were obtained in a group of cardiac patients but, except in hypoxic patients, the mean values obtained by the single breath and the direct (Fick) methods were almost identical. 4. We conclude that our modification of the single breath method is simple to use and sufficiently reliable for use in humans both at rest and during steady states of light exercise.

Evaluation using dogs of a method for estimating cardiac output from a single breath

1981 ◽  
Vol 50 (1) ◽  
pp. 200-202 ◽  
Author(s):  
M. M. Mohammed ◽  
L. M. Wood ◽  
R. Hainsworth
Keyword(s):  
Cardiac Output ◽  
Pulmonary Blood Flow ◽  
Dilution Method ◽  
Moderate Exercise ◽  
Tolerance Limits ◽  
Dye Dilution ◽  
Single Breath ◽  
Significant Difference ◽  
Anesthetized Dogs ◽  
Single Breath Method

We have evaluated the single-breath method of Kim, Rahn, and Fahri (J. Appl. Physiol. 21: 1338, 1966) using anesthetized dogs (avg wt 26 kg). The systematic error was determined by comparing the single-breath estimates of cardiac output with values obtained by the dye-dilution method. In some dogs the effects of moderate exercise were stimulated by joining the circulations of two dogs. From paired estimates, the random error of the single-breath method was +/- 12% (95% tolerance limits; 23 pairs) over a range of outputs 1.1-5.0 l/min. There was no significant difference between values of cardiac output by the single-breath method and by dye dilution, and in four dogs the dye-dilution values were not significantly different from values of pulmonary blood flow controlled by perfusion. These results indicate that under carefully controlled conditions the single-breath method is capable of providing reliable estimates of cardiac output.

Single-breath breath-holding estimate of pulmonary blood flow in man: comparison with direct Fick cardiac output

1989 ◽  
Vol 76 (6) ◽  
pp. 673-676 ◽  
Author(s):  
A. H. Kendrick ◽  
A. Rozkovec ◽  
M. Papouchado ◽  
J. West ◽  
G. Laszlo
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Pulmonary Blood Flow ◽  
Hold Time ◽  
Normal Subjects ◽  
Breath Holding ◽  
Breath Hold ◽  
Single Breath ◽  
Significant Difference ◽  
Cardiac Disorders

1. Resting pulmonary blood flow (Q.), using the uptake of the soluble inert gas Freon-22 and an indirect estimate of lung tissue volume, has been estimated during breath-holding (Q.c) and compared with direct Fick cardiac output (Q.f) in 16 patients with various cardiac disorders. 2. The effect of breath-hold time was investigated by comparing Q.c estimated using 6 and 10 s of breath-holding in 17 patients. Repeatability was assessed by duplicate measurements of Q.c in the patients and in six normal subjects. 3. Q.c tended to overestimate Q.f, the bias and error being 0.09 l/min and 0.59, respectively. The coefficient of repeatability for Q.c in the patients was 0.75 l/min and in the normal subjects was 0.66 1/min. For Q.f it was 0.72 l/min. There was no significant difference in Q.c measured at the two breath-hold times. 4. The technique is simple to perform, and provides a rapid estimate of Q., monitoring acute and chronic changes in cardiac output in normal subjects and patients with cardiac disease.

Mixed venous CO2 tension during exercise

1980 ◽  
Vol 48 (6) ◽  
pp. 933-938 ◽  
Author(s):  
J. H. Auchincloss ◽  
R. Gilbert ◽  
M. Kuppinger ◽  
D. Peppi
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Output ◽  
Normal Subjects ◽  
Paired Comparisons ◽  
Single Test ◽  
Mean Values ◽  
Series Of Experiments ◽  
Artery Disease ◽  
Rebreathing Method ◽  
Mixed Venous

A series of experiments was undertaken in a total of 95 adult subjects, of whom 25 had coronary artery disease, to evaluate the extrapolation (Defares) CO2 rebreathing method vs. the equilibrium (Collier) method for estimating mixed venous CO2 tension. Collier values were corrected for the downstream effect, whereas Defares values were uncorrected. Although the methods gave similar mean values in separate series with normal subjects walking on a treadmill set at 123 W for 3 min, Collier values had a coefficient of variation (CV) of 2.5% in duplicate determinations and Defares values had a CV of 4.5%. In paired comparisons Defares values averaged either higher or lower than Collier values depending on variations in technique and the analysis of Defares tracings. Collier values were essentially unaffected by the duration of the rebreathing period (10 vs. 15 s). The Collier technique appears to be superior for the exercise evaluation of cardiac output in healthy and diseased subjects when the goal is obtain values at 82 or 123 W in single test sessions.

A COMPARISON OF TWO METHODS FOR MEASUREMENT OF ALDOSTERONE SECRETION RATE IN MAN

1966 ◽  
Vol 53 (2) ◽  
pp. 177-188 ◽  
Author(s):  
P. Lund-Johansen ◽  
T. Thorsen ◽  
K. F. Støa
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Secretion Rate ◽  
Aldosterone Secretion ◽  
Simple Method ◽  
Mean Values ◽  
Pathological Conditions ◽  
Significant Difference ◽  
Derivative Method ◽  
The Mean

ABSTRACT A comparison has been made between (A), a relatively simple method for the measurement of aldosterone secretion rate, based on paper chromatography and direct densitometry of the aldosterone spot and (B) a more elaborate isotope derivative method. The mean secretion rate in 9 normal subjects was 112 ± 26 μg per 24 hours (method A) and 135 ± 35 μg per 24 hours (method B). The »secretion rate« in one adrenalectomized subject after the intravenous injection of 250 μg of aldosterone was 230 μg per 24 hours (method A) and 294 μg per 24 hours (method B). There was no significant difference in the mean values, and correlation between the two methods was good (r = 0.80). It is concluded that the densitometric method is suitable for clinical purposes as well as research, being more rapid and less expensive than the isotope derivative method. Method A also measures the urinary excretion of the aldosterone 3-oxo-conjugate, which is of interest in many pathological conditions. The densitometric method is obviously the less sensitive and a prerequisite for its use is an aldosterone secretion of 20—30 μg per 24 hours. Lower values are, however, rare in adults.

Force-velocity relationship of expiratory muscles in normal subjects

1982 ◽  
Vol 52 (4) ◽  
pp. 930-938 ◽  
Author(s):  
Y. Kikuchi ◽  
H. Sasaki ◽  
K. Sekizawa ◽  
K. Aihara ◽  
T. Takishima
Keyword(s):  
Respiratory Muscles ◽  
Normal Subjects ◽  
Contractile Element ◽  
Shortening Velocity ◽  
Mean Values ◽  
Significant Difference ◽  
Velocity Relationship ◽  
Force Velocity ◽  
Expiratory Muscles ◽  
Relationship Of

We examined the force-velocity relationship of the respiratory muscles in normal subjects under nearly isotonic conditions, taking into consideration the pleural pressure (Ppl) changes during maximum forced expirations (MFE). We used an electromagnetic valve (EMV) to select the Ppl value at the onset of mouth flow; and both a pressure reservoir and a variable resistance to control the Ppl changes after the opening of the EMV during MFE. To simulate isotonic conditions and to obtain the shortening velocity of the contractile element (CE), we mathematically corrected the velocity of the series elastic component (SEC), using a modified version of Hill's equation. Although the maximum tension at total lung capacity (TLC) [1,156 +/- 215 (SD) g/cm] was larger than that at functional residual capacity (FRC) (782 +/- 97 g/cm) there was no significant difference in the maximum shortening velocity, 3.4 +/- 1.0 and 3.2 +/- 0.8 circumference/s at TLC and FRC, respectively. The mean values of k (slope) for the SEC at TLC and FRC were 19 +/- 4 and 18 +/- 5 circumference-1, respectively, and they were not significantly different. We concluded that the force-velocity relationship of the expiratory muscles exhibited the same mechanical properties as that of the other skeletal muscles.

Urinary excretion of glycated protein determined with a specific radioimmunoassay

1991 ◽  
Vol 37 (4) ◽  
pp. 504-507 ◽  
Author(s):  
Chizuko Ukita ◽  
Mitsushige Nishikawa ◽  
Akira Shouzu ◽  
Mitsuo Inada
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Mean Values ◽  
Specific Radioimmunoassay ◽  
Glycated Protein ◽  
Highly Sensitive ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract We developed a simple and highly sensitive RIA for glycated protein (GP), and used it to measure GP in serum and urine from 15 normal controls and 30 diabetics (14 with urinary excretion rate of albumin, Ualb less than 15 micrograms/min, group A; nine with 15 less than or equal to Ualb less than or equal to 150 micrograms/min, group B; and seven with Ualb greater than 150 micrograms/min, group C). The mean serum concentration of GP was above normal in all groups of diabetics, and the mean glycation ratios of serum protein (SGP) were higher in groups B and C than in normal subjects. Urinary concentrations of GP also were increased in groups B and C, although the glycation ratio of urinary protein (UGP) was decreased in group C. Consequently, the selectivity of urinary excretion of GP (UGP/SGP) was significantly decreased in group C. Moreover, there was a significant difference in the mean values of selectivity between groups of patients with various degrees of retinopathy. We suggest that measurements of serum and urinary GP are useful to evaluate the progression of diabetic complications.

Effect of analyzer on determination of mixed venous PCO2 and cardiac output during exercise

1995 ◽  
Vol 79 (3) ◽  
pp. 1032-1038 ◽  
Author(s):  
L. Hornby ◽  
A. L. Coates ◽  
L. C. Lands
Keyword(s):  
Cardiac Output ◽  
Gas Mixture ◽  
Arterial Pco2 ◽  
Venous Pco2 ◽  
The Face ◽  
High O2 ◽  
Collision Broadening ◽  
Rebreathing Methods ◽  
Mixed Venous

Cardiac output (CO) during exercise can be determined noninvasively by using the indirect Fick CO2-rebreathing technique. CO2 measurements for this technique are usually performed with an infrared analyzer (IA) or mass spectrometer (MS). However, IA CO2 measurements are susceptible to underreading in the face of high O2 concentrations because of collision broadening. We compared an IA (Ametek model CD-3A) with a MS (Marquette model MGA-1100) to see the effect this would have on mixed venous PCO2 (PVCO2) and CO measurements. After calibration with room air and a gas mixture of 5% CO2–12% O2–83% N2, both devices were tested with three different gas mixtures of CO2 in O2. For each gas mixture, IA gave lower CO2 values than did the MS (4.1% CO2: IA, 3.85 +/- 0.01% and MS, 4.13 +/- 0.01%; 9.2% CO2: IA, 8.44 +/- 0.07% and MS, 9.19 +/- 0.01%; 13.8% CO2: IA, 12.57 +/- 0.15% and MS, 13.82 +/- 0.01%). Warming and humidifying the gases did not alter the results. The IA gave lower values than did the MS for eight other medical gases in lower concentrations of O2 (40–50%). Equilibrium and exponential rebreathing procedures were performed. Values determined by the IA were > 10% higher than those determined by the MS for both rebreathing methods. We conclude that all IAs must be checked for collision broadening if they are to be used in environments where the concentration of O2 is > 21%. If collision broadening is present, then either a special high O2-CO2 calibration curve must be constructed, or the IA should not be used for both arterial PCO2 and PVCO2 estimates because it may produce erroneously low PVCO2 values, with resultant overestimation of CO.

Flow and age dependence of airway closure and dynamic compliance

1975 ◽  
Vol 38 (2) ◽  
pp. 199-207 ◽  
Author(s):  
R. Begin ◽  
A. D. Renzetti ◽  
A. H. Bigler ◽  
S. Watanabe
Keyword(s):  
Flow Rate ◽  
Normal Population ◽  
Dynamic Compliance ◽  
Normal Subjects ◽  
Closing Volume ◽  
Tolerance Interval ◽  
Flow Rates ◽  
Mean Values ◽  
Single Breath ◽  
Expiratory Flow

The influence of expiratory flow rate and age on the results of measurement of closing volume (CV) of the lung have been studied by a nitrogen single-breath method in 66 asymptomatic lifetime nonsmoking normal subjects between 20 and 82 yr of age. Normal was defined as having values for spirometric measurements within a 95% tolerance interval of reported predicted normal mean values. For the CV determination, inspiratory flow rate was held constant at 0.51/s and studies were carried out at expiratory flow rates of 0.25, 0.5, 1.0, and 1.5 1/s. Our results show that CV expressed as a percentage of vital capacity (VC) and the slope of the alveolar plateau increases with increasing flow rate and age. Dynamic compliance (Cdyn) at frequencies corresponding to peak flow rates of 0.5 and 1.5 1/s was also measured and correlated well with the CV results. Frequency dependence of compliance with aging was demonstrated. Nine smokers with normal spirometric measurements and abnormal CV %VC were also studied. Since the results of Cdyn measurement differentiated only two-thirds of the smokers from the normal population, we suggest that the CV method is probably more sensitive than the Cdyn method for the detection of small airway obstruction.

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