title: A Non-Invasive Method for Estimating Cardiopulmonary Variables Using Breath-by-Breath Injection of Two Tracer Gases.
abstract: Conventional methods for estimating cardiopulmonary variables usually require complex gas analyzers and the active co-operation of the patient. Therefore, they are not compatible with the crowded environment of the intensive care unit (ICU) or operating theatre, where patient co-operation is typically impossible. However, it is these patients that would benefit the most from accurate estimation of cardiopulmonary variables, because of their critical condition. This paper describes the results of a collaborative development between an anesthesiologists and biomedical engineers to create a compact and non-invasive system for the measurement of cardiopulmonary variables such as lung volume, airway dead space volume, and pulmonary blood flow. In contrast with conventional methods, the compact apparatus and non-invasive nature of the proposed method allow it to be used in the ICU, as well as in general clinical settings. We propose the use of a non-invasive method, in which tracer gases are injected into the patient's inspired breath, and the concentration of the tracer gases is subsequently measured. A novel breath-by-breath tidal ventilation model is then used to estimate the value of a patient's cardiopulmonary variables. Experimental results from an artificial lung demonstrate minimal error in the estimation of known parameters using the proposed method. Results from analysis of a cohort of 20 healthy volunteers (within the Oxford University Hospitals NHS Trust) show that the values of estimated cardiopulmonary variables from these subjects lies within the expected ranges. Advantages of this method are that it is non-invasive, compact, portable, and can perform analysis in real time with less than 1 min of acquired respiratory data.
authors.affiliation: University of Oxford Department of Engineering Science Institute of Biomedical Engineering Oxford U.K.
authors.forename: Lei
authors.initials: L
authors.lastname: Clifton
authors.affiliation: University of Oxford Department of Engineering Science Institute of Biomedical Engineering Oxford U.K.
authors.forename: David A
authors.initials: DA
authors.lastname: Clifton
authors.affiliation: University of Oxford Nuffield Department of Clinical Neurosciences Nuffield Division of Anaesthetics Oxford U.K.
authors.forename: Clive E W
authors.initials: CE
authors.lastname: Hahn
authors.affiliation: University of Oxford Nuffield Department of Clinical Neurosciences Nuffield Division of Anaesthetics Oxford U.K.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Farmeryy
keywords: Non-invasive; breath-by-breath; cardiopulmonary variables; model; tidal ventilation; tracer gas