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Continuous Cardiac Output Monitoring with a Central Venous Catheter Ultrasound Sensor

使用中心静脉导管超声传感器连续监测心输出量

基本信息

批准号：
10742243
负责人：
MARK EVAN SCHAFER
金额：
$ 45.4万
依托单位：
DREXEL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-01 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10742243
关键词：
Achievement Adoption Anatomy Aorta Arteries Back Blood Blood Vessels Blood flow Cardiac Cardiac Output Caring Catheters Characteristics Clinical Clinical Trials Collaborations Critical Care Critical Illness Devices Diagnostic Doppler Ultrasound Electronics Esophagus Film Flowmeters Functional disorder Geometry Goals Heart Heart Atrium Hospital Personnel Human Resources Hybrids Individual Industry Intensive Care Intensive Care Units Length of Stay Measurement Measures Mechanics Methods Modernization Modification Monitor Motion Movement Noise Nurses Outcome Output Patient Care Patients Perioperative Positioning Attribute Procedures Process Pulmonary artery structure Pump Readiness Research Right atrial structure Risk Safety Schedule Side Signal Transduction Superior vena cava structure Surface System Techniques Technology Testing Therapeutic Thinness Time Transducers Treatment Cost Ultrasonic Transducer Validation Variant Veins Venous aortic valve ascending aorta clinical care cost design flexibility improved improved outcome incremental cost innovation meetings mortality novel porcine model sensor standard of care ultrasound

项目摘要

PROJECT SUMMARY The goal of this research is to develop an innovative device to improve patient treatment in intensive care: a central venous catheter (CVC) that will provide continuous measurement of cardiac output (CO) using a unique Doppler ultrasound technology. Continuous measurements of CO in critically ill patients will transform modern intensive care, by allowing clinicians to direct clinical care moment-to-moment in each patient based on their individual pathophysiology. The proposed transformational technology adds no added risk and little incremental cost, while having the potential to become the standard of care for many of the seven million central lines placed annually in the USA alone. Cardiac output is a highly desired measurement, yet there are no continuous cardiac output measurement systems that have become accepted standards of care in intensive care units. This is due to safety risks from invasive methods such as the Swan-Ganz catheter or the inaccuracy of non-invasive or indirect methods. The system we propose will directly measure cardiac output in the ascending aorta using a novel, double-beam, side- looking diffraction-grating Doppler ultrasound transducer coated on the external surface of a central venous catheter. As noted earlier, this system will add no additional risk for patients in the ICU who already have a CVC inserted and positioned within the superior vena cava (SVC). Innovative aspects of this research include 1) Measuring arterial flow using a Doppler transducer in an adjacent vein (in this case, flow in the ascending aorta from a position within the SVC where the two are in apposition -- but potentially useful wherever artery-vein pairs occur); 2) Applying unique flexible piezopolymer thin-film ultrasound Doppler diffraction-grating transducers onto a central venous catheter; 3) Using two such Doppler transducers to cancel the effect of catheter angle in Doppler flow measurements (i.e., catheter motion within the superior vena cava caused by pulsatile blood flow, patient motion, etc.). The Doppler signals will be used to indicate and establish the correct position of the catheter within the SVC. The Specific Aims of the proposed research are: Aim 1: Design and fabricate double-beam thin-film Doppler transducer arrays designed to be able to measure blood flow in the aorta while swinging freely in the SVC, a blood vessel-to-blood vessel measurement configuration that is unprecedented. Existing Doppler electronics will be modified for the new catheters. Aim 2: Validate that the system resulting from Aim I is at least as accurate as Pulmonary Artery Catheters (Swan- Ganz catheters) when tested in flow phantoms that mimic the anatomy where central lines are placed. Aim 3: Demonstrate in living porcine models that a hybrid central line/cardiac output device is easily positioned, safe, and at least as accurate and precise as a simultaneously used PAC, in-line transit-time flowmeter and transesophageal monitors.

项目总结