The dye dilution method for measurement of cardiac output

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Abstract
The dye dilution method for measuring cardiac output is based on injecting rapidly a known quantity of a dye at one site into the circulatory system, and withdrawing blood at a distal site for determination of a concentration curve of the dye. Flow (Q) is calculated by the formula: where m is the amount of dye injected, mean concentration of dye and t the time of the concentration curve without recirculation. In recent years the only dye used has been indocyanine green (cardiogreen) which has its absorption maximum in the infrared part of the spectrum (at 805 μm) – where oxyhaemoglobin and reduced haemoglobin transmit light equally. Several densitometers for cardiogreen have been developed. The Christian Michelsen Institute densitometer used in our laboratory was found to give very accurate measurements (error < ± 2%) of blood flow in model experiments, for flows ranging from 2 to 12 lmin −1 . The more modern densitometers are usually equipped with computers. The cardiogreen method is probably one of the most accurate methods to study cardiac output during exercise. The error of a single determination of cardiac output values at rest and during exercise is less than ±5%. The method does not allow measurement of ‘beat to beat’ changes, and requires a cardiac output which is stable for approximately 10 s during exercise and 30 s at rest. It has been extensively used in our laboratory to study changes in central haemodynamics in essential hypertension at rest and during exercise, and also to study the haemodynamic alterations induced by anti-hypertensive agents. The method is safe and may be used on an outpatient basis. Another advantage is that the arterial catheter can be used for determination of blood pressure during exercise, when all methods based on arm cuff sometimes give very inaccurate values, particularly for diastolic blood pressure.

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