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Noninvasive Measurement of Cardiopulmonary Blood Volume. Evaluation of the Centroid Method

Cleveland Clinic Foundation, Cleveland, Ohio

Correspondence: For reprints contact: Fetnat M. Fouad, MD, Research Division, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland. OH 44106.

ABSTRACT

Cardiopulmonary blood volume (CPV) and mean pulmonary transit time (MTT) determined by radionuclide measurements (Tc-99m HSA) were compared with values obtained from simultaneous dye-dilution (DD) studies (indocyanine green). The mean transit time was obtained from radionuclide curves by two methods: the "peak-to-peak" time and the interval between the two centroids determined from the right and left-ventricular time-concentration curves. Correlation of dye-dilution MTT and "peak-to-peak" time was significant (r = 0.79, p < 0.001), but its correlation with centroid-derived values was better (r = 0.86, p < 0.001). CPV values (using the centroid method for radionuclide technique) correlated significantly with values derived from dye-dilution curves (r = 0.74, p < 0.001). Discrepancies between the two were greater the more rapid the circulation (r = 0.61, p < 0.01), suggesting that minor inaccuracies of dye-dilution methods, due to positioning or delay of the system, can become magnified in hyperkinetic conditions. The radionuclide method is simple, repeatable, and noninvasive, and it provides simultaneous evaluation of pulmonary and systemic hemodynamics. Further, calculation of the ratio of Cardiopulmonary to total blood volume can be used as an index of overall venous distensibility and relocation of intravascular blood volume.