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Cardiac Output and Hemodynamic Measurement
Cardiac Output and Hemodynamic Measurement
Cardiac Output and Hemodynamic Measurement
Hemodynamic Measurements
Iskander Al-Githmi, MD, FRCSC,
FCCP
Asst. Professor of Surgery
King Abdulaziz University
Historical Perspective
Cardiac Cycle
Phase 1: Atrial contraction
Phase 2: Isovolum contraction
Phase 3: Rapid ejection
Phase 4: Reduced ejection
Phase 5: Isovolum relaxation
Phase 6: Rapid filling
Phase 7: Reduced filling
Cardiac output
Volume of blood ejected from left ventricle
in one minute
It is the determinant of global oxygen
transport from the heart to the body
It reflects the efficiency of cardiovascular
system
There no absolute value for cardiac output
measurement
Frank-Starlings Mechanism
SVI = CI / HR
Left ventricular stroke work index
LVSWI = MAP PCWP x SVI x (0.0136)
Laplace Law:
Tension (T)= Pr/t
Afterload per se does not
Alter preload
Ventricular compliance
Compliance = V/P
Given a change in the pressure cause a change
in the volume
Ejection Fraction
Is a fraction of blood ejected by the ventricle
relative to its end-diastolic volume
Questions
Question 1
During a cardiac output reading the thermistor of
the PAC measures the temperature of the:
a. Blood
b. Injectate
c. Pulmonary artery blood
d. Mixing of blood and injectate
Questions
Question 2
Questions
Question 3
Questions
Question 4
A 50- year-old male with myocardial ischemia presents with
the following:
HR 128 BPM
CO 6.2 L/min
MAP 88 mmHg
SVO2 51%
CVP 6 mmHg
PAWP 16
SaO2 94%
Questions
Question 5
Same patient after treatment with NTG and morphine, his
numbers are as follow:
HR 115 BPM
CO 5.1L/min
MAP 84 mmHg
PAWP 13 mmHg
SVO2 61%
CVP 5 mmHg
SaO2 95%
Is he better or worse ?