Non-Invasive Measurement of Cardiac Output by Inert Gas Rebreathing

at Rest and in Exercise

• Quick test (30 seconds)

• Suitable in children and adults at rest and during exercise

• Compact and portable design with integrated test gas cylinder

• FDA and Health Canada approved, CE marked

Rebreathing video

Parameters:

Hemodynamic
CO. . . . . . . . . . . . . . .Cardiac output
CI . . . . . . . . . . . . . . . Cardiac index
SV. . . . . . . . . . . . . . . Stroke volume
SI . . . . . . . . . . . . . . . Stroke index
PBF. . . . . . . . . . . . . . Pulmonary blood flow
VL . . . . . . . . . . . . . . .Lung volume (or FRC)
HR. . . . . . . . . . . . . . . Heart rate
SpO2. . . . . . . . . . . . .Arterial oxygen saturation

Derived hemodynamic
SvO2 . . . . . . . . . . . . Mixed venous oxygen saturation
A-V O2 diff. . . . . . .Arterio-venous O2 saturation difference
VO2. . . . . . . . . . . . . . Oxygen uptake (by rebreathing)
VO2/kg . . . . . . . . . . Oxygen uptake per kg (by rebreathing)
Shunt. . . . . . . . . . . . Intrapulmonary shunt fraction

CPET parameters
Optional

METHOD

Innocor employs the analytical principle of Inert Gas Rebreathing (IGR). During a rebreathing test Innocor measures the relative levels of two inert gases over a few respirations (about 5-6 breaths or 15-20 s). One of the gases is blood soluble (0.5% nitrous oxide, N2O) and the other is insoluble (0.1% sulphur hexafluoride, SF6). N2O is absorbed at a rate which is proportional to the blood flow through the lungs. SF6 is used to determine the lung volume and to account for incomplete mixing and changing lung volume.

Innocor utilizes a photoacoustic infrared gas analyser for simultaneous measurements of N2O, SF6 and CO2, combining fast response with unmatched sensitivity. There is no requirement for daily calibration.

Innocor is validated in an impressive number of papers covering diverse conditions in health and disease, children and adults, and rest and exercise. As an option, Innocor combines cardiac output and metabolic measurements in a cardiopulmonary exercise test using breath-by-breath gas exchange analysis.

Rebreathing animation

PRODUCT

Product data sheet
Innocor product line

Technical Specifications:

Gas analyser
(Photoacoustic Spectroscopy)
Components and ranges . . . . . . . . . . . . . . . . . . N2O 0-2.5%, SF6 0-0.5%, CO2 0-10%
Accuracy after calibration . . . . . . . . . . . . . . . . . . ± 1.5% rel.
Signal-to-noise ratio . . . . . . . . . . . . . . . . . . . . . . . > 1000 @ half-scale (N2O and SF6)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . > 400 @ half-scale (CO2)
Sampling frequency. . . . . . . . . . . . . . . . . . . . . . . 100 Hz
Sampling flow rate . . . . . . . . . . . . . . . . . . . . . . . . 120 ml/min
Rise time (10-90%) . . . . . . . . . . . . . . . . . . . . . . . . < 200 ms

Oxygen sensor (Laser diode absorption spectroscopy)
Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-100%
Accuracy after calibration. . . . . . . . . . . . . . . . . ± 1.5% rel.
Signal-to-noise ratio . .. . . . . . . . . . . . . . . . . . . . . . > 500 @ 21% O2
Sampling frequency. . . . . . . . . . . . . . . . . . . . . . . . 100 Hz
Sampling flow rate (same flow as above). . . 120 ml/min
Rise time (10-90%) . . . . . . . . . . . . . . . . . . . . . . . . < 170 ms

Flowmeter
(Differential pressure pneumotachometer)
Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .±15 l/s
Resolution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . < 1 ml/s
Flow accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ±2% rel. or ±20 ml/s
Volume accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . ±3% rel. or ±50 ml
Sampling frequency. . . . . . . . . . . . . . . . . . . . . . . 100 Hz

Rebreathing valve
(Pneumatic, with silicone valve insert)
Deadspace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 ml
Flow resistance without bacterial filter. . . . 1.5 cm H2O @ 5 l/s

Gas supply
Gas composition. . . . . . . . . . . . . . . . . . . . . . . . . . 5% N2O, 1% SF6, 94% O2
Cylinder capacity . . . . . . . . . . . . . . . . . . . . . . . . . 18 litres (0.15 l @ 124 bar)
Approx. number of tests (at rest). . . . . . . . . . 75

Pulse oximeter
Oxygen Saturation Range. . . . . . . . . . . . . . . . . . 0 – 100%
Pulse Rate Range . . . . . . . . . . . . . . . . . . . . . . . . . . 40 – 240 BPM

Mechanical
Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 x 29 x 26 cm (W x H x D)
Weight (depending on configuration) . . . . . . 8-9 kg

Electrical
Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100-120 V / 200-240 V, 50/60 Hz
Power consumption. . . . . . . . . . . . . . . . . . . . . . . . 45 W nom., 100 W max.
Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Class I type BF according to EN 60601-1

Environmental
Operating temperature . . . . . . . . . . . . . . . . . . . . . 10 – 40 °C
Operating pressure . . . . . . . . . . . . . . . . . . . . . . . . . 525 – 800 mmHg

SCIENTIFIC LITERATURE

SELECTED SCIENTIFIC PUBLICATIONS USING INNOCOR

Middlemiss et al.
Evaluation of inert gas rebreathing for determination of cardiac output: influence of age, gender and body size.
Hypertens Res. 2018 Dec 18. doi: 10.1038/s41440-018-0179-1. [Epub ahead of print]

Kuhn et al.
Comparative Noninvasive Measurement of Cardiac Output Based on the Inert Gas Rebreathing Method (Innocor®) and MRI in Patients with Univentricular Hearts.
Pediatr Cardiol. 2018 Apr;39(4):810-817. doi: 10.1007/s00246-018-1824-9. Epub 2018 Feb 3.

Agostoni et al.
Reference values for peak exercise cardiac output in healthy individuals.
Chest. 2017 Jan 17. pii: S0012-3692(17)30020-X. doi: 10.1016/j.chest.2017.01.009. [Epub ahead of print]

Guo et al.
Measurement of oxygen consumption in critically ill children: Breath-by-breath method vs mass spectrometry.
Am J Crit Care. 2016 May;25(3):243-8. doi: 10.4037/ajcc2016897. PubMed PMID: 27134231.

Marma et al.
Noninvasive cardiac output estimation by inert gas rebreathing in pediatric and congenital heart disease.
Am Heart J. 2016 Apr;174:80-8. doi: 10.1016/j.ahj.2016.01.006. PubMed PMID: 26995373.

Siebenmann et al.
Cardiac output during exercise: A comparison of four methods.
Scand J Med Sci Sports. 2015 Feb;25(1):e20-7. Epub 2014 Mar 20.

Guo et al.
Measurement of oxygen consumption in children undergoing cardiac catheterization: comparison between mass spectrometry and the breath-by-breath method.
Pediatr Cardiol. 2014 Jun;35(5):798-802. doi: 10.1007/s00246-013-0855-5. PubMed PMID: 24352664.

Farina et al.
Noninvasive cardiac output measurement by inert gas rebreathing in suspected pulmonary hypertension.
Am J Cardiol. 2014 Feb 1;113(3):546-51. Epub 2013 Nov 7.

Raissuni et al.
Can we obtain a noninvasive and continuous estimation of cardiac output? Comparison between three noninvasive methods.
Int Heart J. 2013;54(6):395-400.

Saur et al.
Influence of bag volume on reproducibility of inert gas rebreathing pulmonary blood flow measurements in patients with pulmonary diseases.
Lung. 2013 Oct;191(5):467-73. Epub 2013 Jul 26.

Sheth et al.
Validation of the Innocor device for noninvasive measurement of oxygen consumption in children and adults.
Pediatr Cardiol. 2013 Apr;34(4):847-52. Epub 2012 Oct 30.

Hamm et al.
Evaluation of aortic valve stenosis using a hybrid approach of Doppler echocardiography and inert gas rebreathing.
In Vivo. 2012 Nov-Dec;26(6):1027-33.

Osbak et al.
Non-invasive measurements of cardiac output in atrial fibrillation: inert gas rebreathing and impedance cardiography.
Scand J Clin Lab Invest. 2011 Jul;71(4):304-13. Epub 2011 Mar 10.

McLure et al.
Non-invasive stroke volume measurement by cardiac magnetic resonance imaging and inert gas rebreathing in pulmonary hypertension.
Clin Physiol Funct Imaging. 2011 May;31(3):221-6. Epub 2011 Jan 7.

Saur et al.
The impact of pulmonary disease on noninvasive measurement of cardiac output by the inert gas rebreathing method.
Lung (2010) 188:433–440.

Saur et al.
Non-invasive measurement of cardiac output during atrial fibrillation: Comparison between cardiac magnetic resonance imaging and inert gas rebreathing.
Cardiology 2010;115(3):212-6. Epub 2010 Feb 27.

Corte et al.
Non-invasive assessment of pulmonary blood flow using an inert gas rebreathing device in fibrotic lung disease.
Thorax. 2010 Apr;65(4):341-5.

Fontana et al.
Reliability of measurements with Innocor during exercise.
Int J Sports Med. 2009 Oct;30(10):747-53. Epub 2009 Jul 29.

Saur et al.
Noninvasive determination of cardiac output by the inert-gas-rebreathing method–comparison with cardiovascular magnetic resonance imaging.
Cardiology. 2009;114(4):247-54. Epub 2009 Aug 7.

Saur et al.
Non-invasive determination of cardiac output: Comparison of a novel CW Doppler ultrasonic technique and inert gas rebreathing.
Int J Cardiol. 2009 Aug 14;136(2):248-50. Epub 2008 Jul 26.

Peyton et al.
Reproducibility of cardiac output measurement by nitrous oxide rebreathing.
J Clin Monit Comput. 2009 Aug;23(4):233-6. Epub 2009 Jun 19.

Trinkmann et al.
Inert gas rebreathing: the effect of haemoglobin based pulmonary shunt flow correction on the accuracy of cardiac output measurements in clinical practice.
Clin Physiol Funct Imaging. 2009 Jul;29(4):255-62. Epub 2009 Mar 16.

Cattadori et al.
Noninvasive measurement of cardiac output during exercise by inert gas rebreathing technique.
Heart Fail Clin. 2009 Apr;5(2):209-15.

Sobański et al.
The reliability of noninvasive cardiac output measurement using the inert gas rebreathing method in patients with advanced heart failure.
Cardiol J. 2008;15(1):63-70.

Dong et al.
Validation of the use of foreign gas rebreathing method for non-invasive determination of cardiac output in heart disease patients.
J Zhejiang Univ Sci B. 2005 Dec;6(12):1157-62.

Agostoni et al.
Noninvasive measurement of cardiac output during exercise by inert gas rebreathing technique: a new tool for heart failure evaluation.
J Am Coll Cardiol. 2005 Nov 1;46(9):1779-81. Epub 2005 Oct 10.

McEniery et al.
Increased stroke volume and aortic stiffness contribute to isolated systolic hypertension in young adults.
Hypertension. 2005 Jul;46(1):221-6.

Peyton et al.
Non-invasive measurement of intrapulmonary shunt during inert gas rebreathing.
Physiol Meas. 2005 Jun;26(3):309-16. Epub 2005 Mar 11.

Damgaard et al.
Effects of ventilation on cardiac output determined by inert gas rebreathing.
Clin Phys & Functional Imaging Vol 25, Iss 3 P 142 – May 2005.

Peyton et al.
Agreement of an inert gas rebreathing device with thermodilution and the direct oxygen Fick method in measurement of pulmonary blood flow.
J Clin Monit Comput. 2004 Dec;18(5-6):373-8.

Gabrielsen et al.
Non-invasive measurement of cardiac output in heart failure patients using a new foreign gas rebreathing technique.
Clin Sci (Lond). 2002 Feb;102(2):247-52.

SUPPORT TEAM

CEO
Peter Clemensen MSc
Direct Tel. +45 63 10 06 02
E-mail: pcle@innovision.dk
Application Specialist
Knud Pedersen MSc
Direct Tel. +45 63 10 06 20
E-mail: kp@innovision.dk
Software R&D Engineer
Arne Thomsen MSc
Direct Tel. +45 63 10 06 19
E-mail: abt@innovision.dk
Director of QA and Regulatory Affairs
Karen Hvid Ipsen MSc, MEEL
Direct Tel. +45 63 10 06 18
E-mail: ki@innovision.dk
Founder and Owner
Jørgen Grønlund Nielsen MD, PhD
Direct Tel. +45 63 10 06 03
E-mail: jgni@innovision.dk
Chief Marketing Officer
Juliánna Juhl-Johansen Zölde-Fejér, MA
+45 50 40 57 25
E-mail: jz@innovision.dk

GET IN TOUCH

Request further information, request a quote or ask for a demo.

Distribution opportunities exist in many locations. Please fill out our Distributor Contact Form and mail it to info@innovision.dk

Other Innovision products:

True Lung Clearance Index (LCI)
in clinical practice using the Innocor
Athletic Vo2 performance testing
Extremely accurate system with low flow resistance