Principles of Biomedical Systems &

Devices
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WEEK 10:
Flow & Volume of Blood
 Measurement of
Flow & Volume of Blood

 A measurement of paramount importance: concentration of O2 and other

nutrients in cells  Very difficult to measure
 Second-class measurement: blood flow and changes in blood volume 
correlate well with concentration
 Third-class measurement: blood pressure  correlates well with blood flow
 Fourth class measurement: ECG  correlates adequately with blood pressure
 How to make blood flow / volume measurements? Standard flow meters,
such as turbine flow meters, obviously cannot be used!
 Indicator-dilution method: cont./rapid injection, dye dilution, thermodilution
 Electromagnetic flowmeters
 Ultrasonic flowmeters / Doppler flowmeters
 Plethysmography: Chamber / electric impedance / photoplethysmography
 Indicator Dilution with Continuous Injection

 Measures flow / cardiac output averaged over several heart beats

Change in [] due to dm dt
continuously added C 
indicator m to volume V dV dt

 Fick’s technique: the amount of a substance (O2) taken up by an organ /

whole body per unit time is equal to the arterial level of O2 minus the
venous level of O2 times the blood flow 
dV dm dt
F 
dt C
Consumption of O2 (mL/min)
Blood flow, liters/min
dm dt
(cardiac output)

Ca  Cv Arterial and venous
concentration of O2 (mL/L of blood)
 Fick’s technique

O 2 consumption(mL/ min)
Cardiac Output 
[O 2 ]a  [O 2 ]v
250 mL/ min
  5 L/ min
190mL / L  140mL/L

 How is dm/dt (O2 consumption) measured?

 Where and how would we measure Ca and Cv? (Exercise)
 Indicator Dilution with
Rapid Injection

 A known amount of a substance, such as a dye or radioactive

isotope, is injected into the venous blood and the arterial
concentration of the indicator is measured through a serious of
measurements until the indicator has completely passed through
given volume.
 The cardiac output (blood flow) is amount of indicator injected,
divided by average concentration in arterial blood.

m
F t
 C (t )dt
0
 Indicator – Dilution Curve

After the bolus 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
alone the dotted curve to t1 if there were no recirculation. However, 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 Example
 Dye Dilution

 In dye-dilution, a commonly used dye is indocyanine green

(cardiogreen), which satisfies the following
 Inert
 Safe
 Measurable though spectrometry
 Economical
 Absorption peak is 805 nm, a wavelength at which absorption of blood
is independent of oxygenation
 50%of the dye is excreted by the kidneys in 10 minutes, so repeat
measurements is possible
 Thermodilution

 The indicator is cold – saline, injected into the right atrium using a
catheter
 Temperature change in the blood is measured in the pulmonary
artery using a thermistor
 The temperature change is inversely proportional to the amount of
blood flowing through the pulmonary artery
 Measuring Cardiac Output

Several methods of measuring cardiac output In the Fick method, the indicator is O 2;
consumption is measured by a spirometer. The arterial-venous concentration difference is
measure by drawing simples through catheters placed in an artery and in the pulmonary artery.
In the dye-dilution method, dye is injected into the pulmonary artery and samples are taken
from an artery. In the thermodilution method, cold saline is injected into the right atrium and
temperature is measured in the pulmonary artery.
 Electromagnetic
Flowmeters
 Based on Faraday’s law of induction that a conductor that moves
through a uniform magnetic field, or a stationary conductor placed
in a varying magnetic field generates emf on the conductor:

When blood flows in the vessel with

velocity u and passes through the
magnetic field B, the induced emf e
measured at the electrodes is.
L
e   u  B  dL
0
For uniform B and uniform velocity profile u,
the induced emf is e=BLu. Flow can be
obtained by multiplying the blood velocity u
with the vessel cross section A.
 Electromagnetic
Flowmeter Probes
• Comes in 1 mm increments for
1 ~ 24 mm diameter blood vessels
• Individual probes cost $500 each
• Made to fit snuggly to the vessel
during diastole
• Only used with arteries, not veins,

as collapsed veins during diastole

lose contact with the electrodes
• Needless to say, this is an
INVASIVE measurement!!!
• A major advantage is that it can
measure instantaneous blood
flow, not just average flow
 Ultrasonic Flowmeters

 Based on the principle of measuring the time it takes for an acoustic

wave launched from a transducer to bounce off red blood cells and
reflect back to the receiver.
 All UT transducers, whether used for flowmeter or other
applications, invariably consists of a piezoelectric material, which
generates an acoustic (mechanical) wave when excited by an
electrical force (the converse is also true)
 UT transducers are typically used with a gel that fills the air gaps
between the transducer and the object examined
 Near / Far Fields
 Due to finite diameters, UT transducers produce diffraction patterns,
just like an aperture does in optics.
 This creates near and far fields of the UT transducer, in which the
acoustic wave exhibit different properties
 The near field extends about dnf=D2/4λ, where D is the transducer
diameter and λ is the wavelength. During this region, the beam is
mostly cylindrical (with little spreading), however with nonuniform
intensity.
 In the far field, the beam diverges with an angle sinθ=1.2 λ/D, but the
intensity uniformly attenuates proportional to the square of the distance
from the transducer

Higher frequencies and larger

transducers should be used for near
field operation. Typical operating
frequency is 2 ~ 10 MHz.
 UT Flowmeters

Zero-crossing
detector / LPF

Determine
direction

High acoustic
impedance material
 Transit time flowmeters
Effective velocity of sound in blood: velocity of sound (c) +
velocity of flow of blood averaged along the path of the ultrasound (û)

û=1.33ū for laminar flow, û=1.07ū for turbulent flow

ū: velocity of blood averaged over the cross sectional area, this is different
than û because the UT path is along a single line not over an averaged of
cross sectional area

Transit time in up/down stream direction:

distance D
t 
conduction velocity c  uˆ cos
Difference between upstream and downstream directions

2 Duˆ cos  2 Duˆ cos 

t  2

ˆ2 2
( c  u cos  ) c2
 Transit Time
Flowmeters

The quantity ∆T is typically very small

and very difficult to measure,
particularly in the presence of noise.
Therefore phase detection techniques
are usually employed rather then
measuring actual timing.
 Doppler
Flowmeters

 The Doppler effect describes the change in the frequency of a

received signal , with respect to that of the transmitted signal, when
it is bounced off of a moving object.
 Doppler frequency shift
Source signal Speed of blood flow
frequency (~150 cm/s)
Angle between UT beam
and flow of blood
2 f o u cos
fd 
c

Speed of sound in blood

(~1500 m/s)
 Doppler
Flowmeters

u
F   f s (cos  cos  )
c
 Problems Associated with
Doppler Flowmeters
 There are two major issues with Doppler flowmeters
 Unlike what the equations may suggest, obtaining direction information is
not easy due to very small changes in frequency shift that when not in
baseband, removing the carrier signal without affecting the shift frequency
becomes very difficult
 Also unlike what the equation may suggest, the Doppler shift is not a single
frequency, but rather a band of frequencies because
• Not all cells are moving at the same velocity (velocity profile is not
uniform)
• A cell remains within the UT beam for a very short period of time; the
obtained signal needs to be gated, creating side lobes in the frequency
shift
• Acoustic energy traveling within the beam, but at an angle from the bam
axis create an effective ∆θ, causing variations in Doppler shift
• Tumbling and collision of cells cause various Doppler shifts
 Directional Doppler

 Directional Doppler borrows the quadrature phase detector

technique from radar in determining the speed and direction of an
aircraft.
 Two carrier signals at 90º phase shift are used instead of a single
carrier. The +/- phase difference between these carriers after the
signal is bounced off of the blood cells indicate the direction,
whereas the change in frequency indicate the flowrate
 Directional Doppler

(a) Quadrature-phase detector. Sine and cosine signals at the carrier frequency are summed with
the RF output before detection. The output C from the cosine channel then leads (or lags) the
output S from the sine channel if the flow is away from (or toward) the transducer. (b) Logic
circuits route one-shot pulses through the top (or bottom) AND gate when the flow is away from
(or toward) the transducer. The differential amplifier provides bi-directional output pulses that
are then filtered.