Indicator Dilution Method of Blood Flow Measurement

Indicator Dilution that uses continuous infusion (Indicator – Oxygen)- samples from artery &Pulmonary artery

• Indicator Dilution method that uses rapid injection

• Dye dilution -indocyanine green – cardio green dye injected to pulmonary artery – samples from artery

• Thermo Dilution – cold saline- injected to RIGHT ATRIUM temperature is measured in pulmonary artery

An Indicator I is mixed with the blood with known injection rate.

• The Concentration C of the indicator is measured after mixing.

• Then the flow

When a given quantity of m0 of an indicator is added to a volume V, the resulting

Concentration C of the indicator is given by C = m0/V

When an additional quantity m of indicator is then added, the incremental increase in concentration is ΔC = m/V

When the fluid volume in the measured space is continuously removed and replaced, then in order to maintain a
fixed change in concentration, a fixed quantity of indicator per unit time must be added continuously.

ΔC = (dm/dt) / (dV/dt)

• Then the Flow, F=dV/dt = (dm/dt)/ ΔC

Bolus {Bolus is a relatively large volume of fluid or dose of a drug or test substance given intravenously and
rapidly to hasten or magnify a response; in radiology, rapid injection of a large dose of contrast medium } is
injected at time A

• There is a transportation delay before the concentration begins rising at time B.

• After the peak is passed, the curve enters an exponential decay region between C and D, which would continue
decaying along the dotted curve to t1 if there were no recirculation.

• Recirculation causes a second peak at E before the indicator becomes thoroughly mixed in the blood at F.

• The dashed curve indicates the rapid recirculation that occurs when there is a hole between the left and right

Sides of the heart

An increment of blood of volume dV passesthe sampling site in time dt.

• Quantity of indicator dm . contained in dV is the concentration C(t) times incremental

volume. Hence dm =C(t) dV . Dividing by dt, we obtain (dm/dt)= C(t) (dV/dt)

dm= Fi C(t) dt

where t1 is the time at which all effects of the first pass of the bolus have died out (point E).

• The integrated quantity (∫ C(t) dt) ) is equal to the shaded area in Figure we can obtain it by

Counting squares or using a planimeter.

• If the initial concentration of indicator is not zero—as may be the case when there is

Residual indicator left over from previous injections( C(t) - > Δ C(t) )
SPIROMETRY

A technique used to measure air flow in and out of the lungs.

A recording of lung volumes and capacities defined by the respiratory process. These recordings may be static
(untimed) or dynamic (timed).

It measures lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and
exhaled. Spirometry is helpful in assessing breathing patterns that identify conditions such as asthma, pulmonary
fibrosis, cystic fibrosis, and COPD(Chronic obstructive pulmonary disease) . It is also helpful as part of a system of
health surveillance, in which breathing patterns are measured over time

Spirometry is indicated for the following reasons:

1. to diagnose or manage asthma

2. to detect respiratory disease in patients presenting with symptoms of breathlessness, and to distinguish
respiratory from cardiac disease as the cause
3. to measure bronchial responsiveness in patients suspected of having asthma
4. to diagnose and differentiate between obstructive lung disease and restrictive lung disease