Foundation of Cardiac Surgery Development, Artificial Heart Lab,, Zabrze, Poland.
Biomed Eng Online. 2012 May 20;11:24. doi: 10.1186/1475-925X-11-24.
In spite of numerous non-invasive examinations the "gold clinical standard" of cardiac output measurements is the invasive pulmonary artery catheterization by means of the Swan-Ganz catheter and the application of the thermodilution method to estimate the blood flow. The results obtained by means of thermodilution are sensitive to many physical and biological disturbances. The unreliability of this method amounts to 20-45% and depends on the given variant of the method. Therefore some other method, more accurate and resistant to disturbances, was looked for. This paper presents a new approach to cardiac output measurements, based on cross-correlation signal analysis. The goal of investigations was to verify experimentally the application of the cross-correlation method of cardiac output measurements.
In 99.2% of the examined cases the extreme of the cross-correlation function was easy to be estimated by numerical algorithms. In 0,8% of the remaining cases (with a plateau region adjacent to the maximum point) numerical detection of the extreme was inaccurate. The typical unreliability of the investigated method amounted o 5.1% (9.8% in the worst case). Investigations performed on a physical model revealed that the unreliability of cardiac output measurements by means of the cross-correlation method is 3-5 times better than in the case of thermodilution.
The performed investigations and theoretical analysis have shown, that the cross-correlation method may be applied in cardiac output measurements. This kind of measurements seems to be more accurate and disturbance-resistant than clinically applied thermodilution.
尽管有许多非侵入性检查,但心脏输出量测量的“金临床标准”是通过 Swan-Ganz 导管进行有创肺动脉导管插入术,并应用热稀释法来估计血流。热稀释法获得的结果对许多物理和生物干扰很敏感。该方法的不可靠性为 20-45%,具体取决于给定的方法变体。因此,寻找了其他更准确且抗干扰的方法。本文提出了一种基于互相关信号分析的新的心脏输出量测量方法。研究的目的是通过实验验证互相关方法在心脏输出量测量中的应用。
在 99.2%的检查情况下,通过数值算法很容易估计互相关函数的极值。在其余 0.8%的情况下(与最大值相邻的平台区域),极值的数值检测不准确。该方法的典型不可靠性为 5.1%(最差情况下为 9.8%)。在物理模型上进行的研究表明,与热稀释法相比,互相关法测量心脏输出量的不可靠性提高了 3-5 倍。
进行的研究和理论分析表明,互相关法可应用于心脏输出量测量。与临床应用的热稀释法相比,这种测量方法似乎更准确且抗干扰性更强。