Measurement of flow in large veins by the continuous thermodilution method

Simple methods for measuring percutaneously blood flow in veins characterized by a large oscillatory component of flow are lacking. Therefore, a thermodilution technique with a constant infusion rate was used for the measurement of inferior vena cava flow in anesthetized dogs. The accuracy of the method was studied both in an artificial circuit and in in vivo experiments. The thermal catheter was introduced upstream in a flow of water ranging from 50 to 1,200 ml/min produced in an artificial circuit maintained at 37 degrees C. With a volume of cold injectate of 43 ml/20s, the correlation between the values obtained by direct measurement and by thermodilution technique was highly significant (r = 0.993; n = 37) with a slope practically equal to 1.0 (Y = 1.03 X + 2.42). With the thermal catheter introduced through the jugular vein and an electromagnetic flowmeter probe placed around the exposed vessel, volumetric flows were registered in the subhepatic vena cava, infrarenal vena cava, as well as renal and iliac veins of eight dogs. Comparison of the values obtained by the two techniques yielded a regression equation of Y = 0.96 X + 34.31 with a correlation coefficient r = 0.943 (range 50-1,000 ml/min; n = 40). The continuous injection method was as accurate at low flows as at high. Qualitatively, thermodilution curves were comparable to electromagnetic flowmeter curves, reproducing instantaneously the cyclic respiratory variations. The method is thus particularly suitable for use in those veins in which there is a large oscillatory component of flow.