생체계측 II Report #9 2005200427 송성진 Medical Instrumentation II.
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Transcript of 생체계측 II Report #9 2005200427 송성진 Medical Instrumentation II.
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생체계측 II Report #9
2005200427 송성진
Medical Instrumentation II
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<Topics Covered in Chapter 8>
• Cardiac Output Fick Technique Method Indicator Dilution Thermodilution• Electromagnetic Flowmeter (Not good)• Ultrasound Flowmeters• Plethysmography
Medical Instrumentation II
Chap 8. Part I. Flow and Volume of Blood
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1. Indicator Dilution Method
• Fick Method• Indicator Dilution using
rapid injection• Thermodilution
Medical Instrumentation II
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Medical Instrumentation II
iF oF FFF oi )(densityCi )(densityCo
dt
dm(Infusion rate) -> We Known
FCdt
dmFC oi (Mass balance
equation)
min/min// gllg
io CCdt
dmflowF )(Conclusio
n :
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Fick Method
Medical Instrumentation II
dt
dm
Substitution of Equation!
ao CC
vi CC
(O₂ density of Artery Blood)
(O₂ density of Vein Blood)
(O₂ Consumption, L/min)measure By Spirometer
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Indicator Dilution using rapid injection
Medical Instrumentation II
Dye Dilution MethodIndocyanine green (cardiogreen)
Extrapolation
Indictor dilution curve
)(tC
tBolus injection
Recirculation
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Medical Instrumentation II
Find Area!
)(tCdv
dm dvtCdm )(
FtCdt
dvtCdvtC
dt
d
dt
dm )()()(
TT
dttCFdmm00
)(
T
dttC
mF
0)(
Conclusion :
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Medical Instrumentation II
Weak Point : Once dye get an injection, it remains in our body.
The dye should be excreted in the urine. In order
to remeasure the blood flow, you should wait for a long time.
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Thermodiltion (standard)
Medical Instrumentation II
T
tBolus injection
Weak Point : We unknown temperature of Right artium.
Using 4 lumen catheter(Swan-Ganz catheter)
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Medical Instrumentation II
]/[)(
3
0
smdttTC
QF T
bbb
Conclusion :
][JCTVQ iiii (Heat content of injectate)
]/[ 3mkgb
]/[ KkgJCb
(Blood density)
(Specific heat of blood)
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Medical Instrumentation II
-> pressure element, approvaled by 1MHz frequency.Ex)
t
No reflection
Primary Echo
skin
2. Ultra Sound
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Medical Instrumentation II
2
f
v
MHzf
3
Near field
Far field
D
2.1sin
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Transit Time Flowmeter
Medical Instrumentation II
Du
Velocity of RBC, WRC, and plate.
c Velocity of ultrasound.
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Medical Instrumentation II
i ) Down stream ( = Blood flow direction)
ii ) Up stream ( = Blood flow reverse direction)
cosuc
DtD
coscos uc
D
uc
Dttt DU
cosuc
DtU
2222
cos2
cos
cos2
C
Du
uc
Du
Because… C >> ucosφ
Conclusion :
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Continuous Doppler Flowmeter
Medical Instrumentation II
u
c
u
f
f
o
d
cff d
cfo
Doppler frequency shift
Ex) aviation, ship, submarine…
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Medical Instrumentation II
Pulsed Doppler Flowmeter
D
1u2u
3u2u
1u
12321 uuuuu
Flow profile measuremen
t
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Thermal Convection Flowmeter
Medical Instrumentation II
Thermister
f
2T
1T
i ) Bias current -> Thermister heatingii ) T₂Thermister is cooled by thermal convection
Weak Point : Invasive and Probe position is difficult.
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Medical Instrumentation II
-> Volume, blood flow measurement
V
`i Howland Current
Source
Cuff
Artery openVein close
mmHg60
3. Plethysmography
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Medical Instrumentation II
t
Z)(v
Venous Thrombosis
NormalVolume
Cuff On Cuff Out
Slope = flow
Arterial
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Patient monitoring (Respiration monitoring)
Part II. Pulmonary Function Test
Medical Instrumentation II
1. ArchitectureTrachea
Bronchus
Alveoli
Area TT Au ,
AA Au ,
AATT AuAuQ
A
TTA A
Auu
TA uu Because… O₂ & CO₂ diffusion at alveoli
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Medical Instrumentation II
2. Physiological Functions
• O₂ transport into blood stream• CO₂ removal from blood
stream• Homeostasis of pH, Po₂, Pco₂
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Medical Instrumentation II
3. Respiration
• Ventilatory mechamis - RC equivalent circuit model
• Gas transport - Mass balance equation(Diffusion
process)
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Medical Instrumentation II
4. Pressure measurementDifferential pressure transducer
1P 2P
Diaphragm
i )
ii )1P 2P
Diaphragm
2C1C
1x 2x
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Medical Instrumentation II
iii )
Mesh screen
1P 2P
Differential pressure sensor
Q
Flow
Mouth
RQPP 21
R
PPQ 21 Conclusio
n :
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Airpump
Medical Instrumentation II
Ballon sensorHole Ballon
Gas
Pressure sensor
Pv5
MPiv
Control
Pressure
Metal switch
Switch On ->Switch Off ->
v0v5
iPP iPP
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Medical Instrumentation II
5. Flow measurement
• Rotating Vane• Ultrasound Flowmeter• Thermal Convection Flowmeter• Pneumotachometer (standard)
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Medical Instrumentation II
6. Volume measurement-> Plethysmography
t
TLC
FRC
RV
TV (Tidal Volume)
ERC
IC VC
Weak Point : It is Relative value, not absolute value.
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Medical Instrumentation II
Water Spirometer
Water
Air
Pen
Rotating Paper
Mouth
CO₂ absorber
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Medical Instrumentation II
Dry Spirometer
Air (gas)
Mouth
Inspiratory gas
Expiratory gas
Valve
Piston
Gas is Separated by two section
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Medical Instrumentation II
7. FRC measurementHe dilution technique - patient at FRC
- prepare a spirometer of volume VSP and
initial He, concentration of fIHE
- patient breaths tooth spirometer - find He concentration of expiration F
SPFHeFHeIHe VFFFFRC
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Medical Instrumentation II
N₂ washout technique - patient at FRC - prepare a spirometer of O₂, VSP
- patient breaths to the spirometer - Measure N₂ concentration in (FFN₂)
the expiratory.
2)(8.0 FNSP FVFRCFRC
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Medical Instrumentation II
8. Gas concentration measurement
• Mass spetroscophy• Gas chromatography• Infrared spectrography• Raman spectrography• Emission spectrography• Paremagnetic O₂ analyzer
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Medical Instrumentation II
9. Gas transport measurement
Gas distribution test(Single breath N₂ wachout) - RC -> TLC O₂ inspiration - Pause (hold breath) - Expiration and measure fN2
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Medical Instrumentation II
Diffusion test(CO diffusion capacity) - Inspire ω, He in air - fICO, fIHe
- Hold breath for 10sec - Expire to measure FFCO, FFHe
He
He
CO
CO
I
F
F
I
B
ACO f
F
F
f
Pt
vD ln
)47(
60