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

A method for indirect and real-time estimation of the cardiac output of the circulatory system supported by the left ventricular assist device (LVAD) is proposed. This method has low invasiveness and is useful for clinical applications of the LVAD since it needs only two measurements: the rate of blood outflow from the LVAD and the aortic pressure. The 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 method could be implemented in a personal computer system and realize online, real-time estimation of the instantaneous outflow rate of the natural heart. Results obtained in vitro using a mock circulatory system and in vivo using an adult goat show that the method can yield a fairly high correlation coefficient between the true stroke volume of the natural heart and its estimate of more than 0.99 (in vitro) or 0.95 (in vivo). The estimation method thus appears suitable for clinical use.