Computation of aortic flow from pressure in humans using a nonlinear, three-element model.

We computed aortic flow pulsations from arterial pressure by simulating a nonlinear, time-varying three-element model of aortic input impedance. The model elements represent aortic characteristic impedance, arterial compliance, and systemic vascular resistance. Parameter values for the first two elements were computed from a published, age-dependent, aortic pressure-area relationship (G. J. Langewouters et al. J. Biomech. 17:425-435, 1984). Peripheral resistance was predicted from mean pressure and model mean flow. Model flow pulsations from aortic pressure showed the visual aspects of an aortic flow curve. For evaluation we compared model mean flow from radial arterial pressure with thermodilution cardiac output estimations, 76 times, in eight open heart surgical patients. The pooled mean difference was +7%, the SD 22%. After using one comparison per patient to calibrate the model, however, we followed quantitative changes in cardiac output that occurred either during changes in the state of the patient or subsequent to vasoactive drugs. The mean deviation from thermodilution cardiac output was +2%, the SD 8%. Given these small errors the method could monitor cardiac output continuously.