Prediction of cardiac function and stressed blood volume by using positive end-expiratory pressure

Abstract

Background: In acute heart failure (AHF), evaluation of cardiac pumping function, i.e., cardiac output curve (S), and stressed blood volume (V) is essential for hemodynamic management. However, these measurements require an invasive right heart catheterization. In this study, we developed a less invasive method which predicts S and V by using positive end-expiratory pressure (PEEP).Methods: Circulation equilibrium framework determines hemodynamics by S and V. In four mongrel dogs, we measured central venous pressure and cardiac output under various PEEP conditions. We predicted S and V from these hemodynamic variables with or without AHF by using circulatory equilibrium framework.Results: Predicted S (R2 = 0.86, RMSE 5.5 ml/min/kg, PE 32%) and V (R2 = 0.63, RMSE 5.3 ml/kg, PE 25%) were matched well with those measured regardless of AHF.Conclusion: Our proposed method could predict S and V less invasively and may contribute to the safety management of AHF.