What question did this study set out to answer?

To identify the primary hemodynamic determinants of pulmonary blood volume and validate radiocardiographic transit time measurements against the standard double dye-injection method.

January 1, 1970Journal of Clinical InvestigationOpen Access

Determinants of pulmonary blood volume

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Why the study?

Does the radiocardiographic technique accurately measure pulmonary blood volume compared to the double injection of dye in patients undergoing cardiac catheterization?

Population

70 patients undergoing cardiac catheterization, including individuals with normal hemodynamics, chronic…

Comparison

Radiocardiographic technique using precordial… vs Double injection of indocyanine green dye into…

Design

Cross-sectional

Authors

MLMilena L. LewisBellevue Hospital Center JGJulian GnojUnited States Department of Veterans Affairs VFVincent J. FisherUnited States Department of Veterans Affairs

Discussion

Member takes

Implication

May support radiocardiography for pulmonary transit time assessment; leaves open prospective validation before clinical adoption.

Key Points

To identify the primary hemodynamic determinants of pulmonary blood volume and validate radiocardiographic transit time measurements against the standard double dye-injection method.
Measured pulmonary blood volume using radiocardiography in N=49 resting recumbent patients undergoing cardiac catheterization, with and without cardiac or pulmonary disease.
Compared radiocardiography transit time measurements against double injection of dye across 25 paired comparisons in 13 patients.
Performed multiple regression analysis to assess the relationship between pulmonary blood volume, transit time, and various hemodynamic variables.
Transit time measurements showed good agreement between radiocardiography and double dye injection across a range of 4.5 to 21.1 heart cycles, with no statistically significant difference.
Mean transit time varied predominantly with blood flow, whereas pulmonary blood volume varied significantly only with total blood volume and pulmonary venous pressure.
Vascular distensibility metrics, including pulmonary vascular resistance, showed no significant effect on pulmonary blood volume, demonstrating that volume shifts reflect passive vascular bed distention.

Structured PICO

Does the radiocardiographic technique accurately measure pulmonary blood volume compared to the double injection of dye in patients undergoing cardiac catheterization?

Population

70 patients (49 in Group A, 21 in Group B) undergoing cardiac catheterization, including individuals with normal hemodynamics, chronic obstructive pulmonary disease, cor pulmonale, valvular heart disease, and other heart diseases, studied after an overnight fast.

Intervention

Radiocardiographic technique using precordial isotope dilution curves with radioiodinated human serum albumin (RISA) injected via a right atrial catheter to measure pulmonary blood volume and pulmonary mean transit time.

Comparator

Double injection of indocyanine green dye into the pulmonary artery and left atrium (performed in a subset of 13 patients for 25 comparisons).

Outcome

Pulmonary mean transit time (PMTT) and pulmonary blood volume (PBV)surrogate

Radiocardiography is a valid method for measuring pulmonary blood volume, demonstrating that this volume is primarily determined by passive distention related to total blood volume and pulmonary venous pressure.

Limitations

Assumptions regarding size of ventricular chambers and distribution of pulmonary transit times may not be valid for every patient, giving rise to indeterminate errors in measurement of PBV

Cite This Study

Lewis et al. (1970) studied this question.

synapsesocial.com/papers/6a7fcc39e62c735d110fe4a6 https://doi.org/10.1172/jci106216

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Determinants of pulmonary blood volume

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Determinants of pulmonary blood volume

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

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