Advanced Critical Care Monitoring: In-Depth Analysis of Hemodynamics Understanding

hemodynamics

the movement of blood

blood circulation

how are body tissues replenished with oxygen and nutrients?

Cardiac Output

volume of blood ejected each minute during ventricular contractions

4-8 L/min

normal cardiac output

Cardiac Index (CI)

the cardiac output corrected for differences in body size (CO/BSA)

2.5-4 L/min

normal cardiac index

Stroke Volume (SV)

Volume of blood ejected during each ventricular systole

60-130ml

normal stroke volume

Ejection Fraction (EF)

percentage of blood pumped out of the left ventricle during systole

Systemic Vascular Resistance (SVR)

the resistance in the systemic vasculature

50-75%

normal ejection fraction

800-1400 dynes/sec/cm5

normal SVR (left heart)

-preload

-contractility

-afterload

name the 3 components of the stroke volume

4-12 mmHg

normal PAWP (Left heart)

0-6 mmHg

normal CVP (right heart)

Starling's Law

states that the more the myocardium stretches during diastole, the more forceful the contraction in systole

-Lasix (diuretic)

-Nitroglycerine (Vasodilator)

name two agents that will REDUCE preload

-Crystalloids

-Colloids

name the two GENERAL TYPES of preload INCREASERS

crystalloids

these are thin preload increasers

colloids

these are thick preload increasers

crystalloid preload increasers

normal saline and lactate ringers are examples of...

colloid preload increasers

blood, plasma, albumin, Hespan, and Dextran are all examples of...

preload

which component of the stroke volume is most affected by atrial kick?

TRUE: The greater the preload, the greater the force of contraction

True or False: Contractility is influenced by preload

decrease contractility

how will hypocalcemia and hypokalemia affect contractility?

Inotropes

agents that increase contractility are called...

-Norepinephrine

-Epinephrine

-Dobutamine

-Dopamine

-Isoproterenol

(N.E.D.D.I)

name 4 inotropes

decrease contractility

how would hypoxemia affect contractility?

decrease contractility

how would cardiac tamponade affect contractility?

20-120 dynes/sec/cm5

normal PVR (right heart)

vessel status

what factor is afterload most dependent on?

Vasodilators

what TYPE of agents REDUCE afterload?

-nitroprusside

-nitroglycerine

name two vasodilators that reduce afterload

afterload

the amount of resistance in the vessels the heart must push against; resistance to ejection

Vasonconstrictors

what TYPE of agent will INCREASE afterload?

-Norepinephrine

-Epinephrine

-Phenylephrine

-Dopamine

name 4 vasoconstrictors that will increase afterload

Inotrope

what kind of drug is digoxin?

Crystalloid

to increase preload, would we first use a crystalloid or a colloid?