A removable extraluminal Doppler probe for continuous monitoring of changes in cardiac output

To address the problem of monitoring cardiac output in postoperative cardiac patients, a removable, extraluminal pulsed Doppler probe has been constructed which continuously reflects changes in cardiac output by monitoring blood velocity in the ascending aorta. Velocity is related to the frequency of the Doppler shift and the angle at which the ultrasound beam intersects the vessel. A 1 mm2 piezoelectric crystal mounted at a 45 degree angle on the tip of the probe is activated with a 20-MHz range-gated pulsed Doppler, and velocity is determined from Fourier analysis of quadrature data using computer software with a 50-KHz processing range. The device is designed for application to the ascending aorta at the conclusion of a cardiac surgical procedure; and, since mean diameter changes in the ascending aorta have been shown to be very small over a wide range of mean aortic pressures, cardiac output is linearly related to velocity. To test this technique, simultaneous recordings were made from the pulsed Doppler probe and an electromagnetic flow probe in five mongrel dogs over a range of cardiac outputs from 0.5 to 6 l/min for a total of 136 data points. Excellent correlation was found between the electromagnetic flow probe and pulsed Doppler probe data (average r = .98 +/- .006). Average slope between the two was 1.004 and average zero intercept was -0.025 l/min. The catheter is small, stable, has no baseline drift, and continuously and accurately reflects pulsatile changes at high and low flows.