Cardiovascular Devices and Systems

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 proposedmethod 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 NHSTrust) 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. INDEX TERMS Non-invasive, cardiopulmonary variables, breath-by-breath, tracer gas, tidal ventilation, model. I. MOTIVATION Patients are often admitted into the Intensive Care Unit (ICU) due to the need for mechanical ventilatory support using a ventilator [1]. Cardiopulmonary tests could benefit ICU patients significantly, because they could help to determine the most suitable ventilator settings, and help to avoid the common problem of Ventilator Induced Lung Injury (VILI). We aim to measure the following three cardiopulmonary variables: 1) VD, airway dead space volume; i.e., the volume of the conducting airways. The airway is the path that the air follows to enter and exit the lung. 2) VA, lung volume, or alveolar volume, at the end of an expiration. 3) Q̇P, pulmonary blood flow. Measurement of cardiopulmonary variables typically requires the active co-operation of the patient. However, ICU patients depend on complex life support and monitoring equipment, and so are unable to co-operate with clinicians. Hence, ICU patients are the most difficult to assess using conventional cardiopulmonary tests, but their VOLUME 1, 2013 2168-2372/$31.0