The Use of Ascorbate Dilution Curves in Cardiovascular Diagnosis: Applications of a Technic for Direct Intravascular Detection of Indicator

The instrumentation and clinical applications, in this laboratory, of Clark's sodium ascorbate dilution technic are described. With this method the sensing device, a platinum electrode, is introduced directly into the blood stream, and a reducing agent, sodium ascorbate, is used as the indicator. Time-concentration curves may be obtained without the withdrawal of blood. Observations in 90 patients have indicated that the contours of the dilution curves are essentially identical to indocyanine-green dye-dilution curves, except for diminished peripheral recirculation peaks. The ascorbate-dilution technic has been found of particular value when the sensing electrode is incorporated into a cardiac catheter. This method permits injection and sampling of the indicator from the central circulation and greatly facilitates the study of circulatory shunts and of valvular regurgitation.

[1]  E. Braunwald,et al.  A Simplified Technic for the Detection of Patent Ductus Arteriosus and of Other Left‐to‐Right Shunts Originating from the Aorta , 1961 .

[2]  E. Braunwald,et al.  Thermal dilution curves in the study of circulatory shunts. Instrumentation and clinical applications. , 1960, The American journal of cardiology.

[3]  L. C. Clark,et al.  Detection of Right‐to‐Left Shunts with an Arterial Potentiometric Electrode , 1960, Circulation.

[4]  Clark Lc.  Intravascular polarographic and potentiometric electrodes for the study of circulation. , 1960 .

[5]  A. Morrow,et al.  A Simplified Indicator‐Dilution Technic for the Localization of Left‐to‐Right Circulatory Shunts: An Experimental and Clinical Study of Intravenous Injection with Right Heart Sampling , 1959, Circulation.

[6]  Clark Lc,et al.  Detection and direct recording of left-to-right shunts with the hydrogen electrode catheter. , 1959 .

[7]  A. Morrow,et al.  Detection of Pulmonic and Tricuspid Valvular Regurgitation by Means of Indicator Solutions , 1959, Circulation.

[8]  L. C. Clark,et al.  Left-to-Right Shunt Detection by an Intravascular Electrode with Hydrogen as an Indicator , 1959, Science.

[9]  R. Sanders,et al.  An Evaluation of the Nitrous Oxide Method for the Quantification of Left‐to‐Right Shunts: An Experimental Comparison of the Gasometric Technic with Directly Metered Blood Flows , 1959, Circulation.

[10]  A. Goodyer,et al.  Thermal Dilution Curves in the Intact Animal , 1959, Circulation research.

[11]  A. Morrow,et al.  A Method for the Detection and Estimation of Aortic Regurgitant Flow in Man , 1958, Circulation.

[12]  E. Braunwald,et al.  Dye-Dilution Curves from Left Heart and Aorta for Localization of Left-to-Right Shunts and Detection of Valvular Insufficiency , 1957, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[13]  G. Fegler,et al.  MEASUREMENT OF CARDIAC OUTPUT IN ANÆSTHETIZED ANIMALS BY A THERMO‐DILUTION METHOD , 1954 .

[14]  Wood Eh,et al.  A method for the continuous recording of Evans blue dye curves in arterial blood, and its application to the diagnosis of cardiovascular abnormalities. , 1951 .

[15]  W. F. Hamilton,et al.  STUDIES ON THE CIRCULATION , 1932 .

[16]  W. Milnor,et al.  Distortion of indicator-dilution curves by sampling systems. , 1960, Journal of applied physiology.

[17]  G. Fegler,et al.  Measurement of cardiac output in anaesthetized animals by a thermodilution method. , 1954, Quarterly journal of experimental physiology and cognate medical sciences.

[18]  D. Riesman.  Thomas Sydenham, Clinician* Read before the Section on Medical History of the College of Physicians of Philadelphia, January 12, 1925, and by invitation before the Section on Historical Medicine of the New York Academy of Medicine, February 26, 1925. , 1925, Annals of medical history.