Real-time cardiac output estimation of the circulatory system under left ventricular assistance

A new method for indirect and real-time estimation of the cardiac output of the circulatory system supported by the left ventricular assist device (LVAD) was proposed. This method has low invasiveness and is useful for clinical application of the LVAD since it needs only two measurements: the outflow rate of blood from the LVAD and the aortic pressure. The proposed method is based on a system identification technique for the time series model of the cardiovascular system and requires less computational time than other methods with similar estimation accuracy. Hence, the proposed method could be implemented in a personal computer system and realize the on-line and real-time estimation of the instantaneous outflow rate of the natural heart. The efficiency and limitation of the method were discussed on the basis of the results obtained from in vitro experiment using a mock circulatory system and in vivo experiment using an adult goat. It was revealed that the method could obtain a fairly high correlation coefficient between the true stroke volume of the natural heart and its estimate of more than 0.99 (in vivo) or 0.95 (in vivo). This means that there is a fair possibility of applying the proposed estimation system to the clinical use.