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Chapter 14. Dr. D. Washington. Cardiac Output. I. Definition: C.O. (L/min)= heart rate X stroke volume or(ml/min) (beats/min)(ml/beat) II. Cardiac Index (C.O./m 2 body surface) III. Regulation of cardiac output A. Rate of Venous return (limiting factor) 1. Peripheral resistance

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Presentation Transcript
chapter 14

Chapter 14

Dr. D. Washington

cardiac output
Cardiac Output

I. Definition:

C.O. (L/min)= heart rate X stroke volume

or(ml/min) (beats/min)(ml/beat)

II. Cardiac Index (C.O./m2 body surface)

III. Regulation of cardiac output

A. Rate of Venous return (limiting factor)

1. Peripheral resistance

2. Mean systemic pressure (filling)

3. Right atrial pressure

therefore V.R. = mean systemic pressure - Rt. atrial. P

total peripheral resistance

cardiac output1
Cardiac Output

B. Pumping Effectiveness (permissive regulator)

1. Starling’s Law

2. Starling’s Curve

3. Sympathetic & Drug Actions

a. Chronotropic Affects (heart rate)

b. Inotropic Affects (strength of contraction)

positive inotropic ‘’ ‘’ ‘’

negative inotropic ‘’ ‘’ ‘’

4. Relative terms

a. End diastolic vol (pres) 120 ml/ventricle

b. End systolic vol ‘’ 40 ‘’ ‘’

c. Stroke volume 80 ml/beat

starling s curve
Starling’s Curve

systole

intensity of

contraction

diastole

Filling pressure

(myocardial fiber length)

slide8

End-diastolic volume

Venous return

Negative

Intrathoracic

pressure

Blood Volume Venous pressure

Breathing

Urine Tissue-fluid Venoconstriction Skeletal

volume volume muscle pump

Sympathetic Nerve stimulation

measurement of cardiac output
Measurement of Cardiac Output

I. Direct or Invasive

a. Fick method

B. Indicator Dilution method

II. Indirect or Non-invasive

a. Echocardiography

b. Computed Tomography

c. Radionuclide Imaging

cardiac output2
Cardiac Output

A. Fick Method

C.O. =

O2 consumption = 250 ml/min

Arterial Blood = 190 ml/L

Venous Blood = 140 ml/L

C.O. = 250 ml/min = 5 L/min

O2 consumption (ml/min)

[AO2] - [VO2]

ml/min

cardiac output3
Cardiac Output

Fick Method

Lungs

O2 consumption

= 250 ml/min

O2 = 140 ml/L Rt heart

O2 = 190 ml/L Lt heart

Cardiac Output = 5,000 ml/min

other techniques currently used to measure cardiac output
Other Techniques Currently Used to Measure Cardiac Output

Radionuclide (gamma camera)

Echocardiography

Computed Tomography