Mechanical Ventilation Cardiac Output Measurement With Pulse Pressure

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Solution Overview

Problem

Existing methods for determining cardiac output and effective pulmonary blood flow in mechanically ventilated patients are inaccurate due to the assumption of constant perfusion during breath sequences, which is often incorrect, leading to errors in CO2 level measurements and subsequent calculations.

Innovation Solution

A method that measures relative variations in cardiac output or effective pulmonary blood flow by incorporating uncalibrated pulse pressure signals into Fick-based techniques, compensating for changes in perfusion by using uncalibrated pulse pressure data to adjust cardiac output or EPBF determinations.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If differential Fick techniques are used to determine cardiac output or EPBF from changes in CO2 elimination and partial pressure of CO2, then cardiac output or EPBF can be estimated from measurable changes in ventilation, but the assumption of constant perfusion during the analysed sequence of breaths introduces substantial error in the determination

Engineering Contradiction:
Improveaccuracy of cardiac output or EPBF determinationVSAvoidvalidity of constant perfusion assumption
Core Design Contradiction:
Measurement precisionVSReliability

Solution Approach 1:

The patent incorporates pulse pressure measurements as a feedback mechanism to detect and compensate for perfusion variations during the breath sequence. By continuously monitoring pulse pressure and using it to adjust the cardiac output or EPBF calculation, the system accounts for changes in thoracic pressure and perfusion that occur during prolonged expiration phases, thereby resolving the contradiction between using differential Fick techniques and maintaining the constant perfusion assumption

Inventive Principle:
Principle #23Feedback

Solution Approach 2:

The patent introduces pulse pressure as an intermediary parameter that mediates between the ventilation changes and the cardiac output/EPBF determination. The pulse pressure signal serves as an indicator of perfusion status, allowing the system to weight or adjust the Fick-based calculations based on actual perfusion conditions, thus bridging the gap between the theoretical constant perfusion assumption and the actual varying perfusion reality

Inventive Principle:
Principle #24Intermediary (Mediator)

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

Improves the accuracy of cardiac output and EPBF measurements by accounting for variations during breath sequences, reducing the need for complex calibration techniques and equipment, and providing real-time monitoring capabilities.

Implementation Method 1

measuring also a relative variation in cardiac output or effective pulmonary blood flow during the sequence of analysed breaths

Methodology Applied
Scientific EffectPulse pressure variation:

Implementation Method 2

Most non-invasive respiratory based methods for determination of cardiac output or EPBF are based on some form of the basic physiological principle known as the Fick principle. According to the Fick equation, the cardiac output of a patient may be determined using the following basic relationship: Q = VCO2 / (CvCO2 - CaCO2)

Methodology Applied
Scientific EffectFick principle:

Data Source

PatentEP3451922B1Determination of cardiac output or effective pulmonary blood floow during mechanical ventilation
Publication Date: 2025.09.24 MAQUET CRITICAL CARE
  • EP3451922B1 patent drawingFigure 1~2
  • EP3451922B1 patent drawingFigure 3
  • EP3451922B1 patent drawing

AI summary

The present disclosure relates to a method for determination of cardiac output or EPBF of a mechanically ventilated subject (3). The method comprises the steps of introducing (S2) a change in the effective ventilation of the subject (3), measuring (S1) expiratory flow and CO2 during a sequence of analysed breaths during which the effective ventilation of the subject (3) varies, and determining (S3) the cardiac output or EPBF of the subject (3) using the flow and CO2 measurements. The method further comprises the steps of measuring (S1) also a relative variation in cardiac output or EPBF during the sequence of analysed breaths, and using the relative variation in the determination (S3) of cardiac output or EPBF.