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Hemodynamics part 2
Terms in this set (34)
how do we calculate stroke volume?
how we calculate CO?
always calculate SV into mL!!
stroke volume is what?
aka- SV index
1) contractility of heart
2 volume of blood
3) amount of venous return to heart
there for if trauma patient has loss of blood and contractility of heart their SV will be decreasing.
how is SVI calculated?
what is normal BSA for men?
what is normal BSA for women?
assuming the heart rate remains the same, as the SVI increases the CI (cardiac Index) will increase, as the SVI decreases the CI will decrease
they are directly related.
how do we calculated CI?
stroke work index
what does RVSWI measure?
how well the right vent is able to contract, if low could be core pulmonale, usually secondary to a primary pulmonary problem
what does LVSWI measure?
how well the L vent is able to contract, if low CHF
Positive inotropic drugs do what?
(increase SV, CO, SVI)
Negative intropic drugs do what?
what abnormal conditions increase factors of heart contractility?
septic shock (early stages, hyperthermia, hypervolemia, decreased vascular resistance
what abnormal conditions decrease factors of heart contractility?
septic shock (late stages), congestive heart failure, hypovolemia, increased vascular resistance
As blood flows through pulmonary, then systemic vascular system, there is a resistance to flow.
pulmonary system is a lower resistance system
systemic system is a higher resistance system
As vascular resistance increases blood pressure increases
which in turn increases ventricular afterload
how do we calculate vascular resistance?
what is pulmonary vascular resistance?
-vascular tone (constricted or dilated) of pulmonary vessels
-reflects input by the patients lung volumes
-reflects the function of the R vent and patients lung volumes
how is PVR calculated?
what factors increase PVR?
acidemic, hypoxia, P emboli, hypercapnia
what is systemic vascular resistance?
reflects the resistance the L ventricle has to work against
How is SVR calculated?
what are vascoconstricting agents that increase SVR?
dopamine, norepinephrine, epinephrine, phenyleprine
what is shock?
hemodynamic disturbance can be high or low BP, leads to inadequate perfussion and oxygenation of tissues.
what is pulmonary hypertension?
high blood pressure in arteries of lungs- person have to have swaun cath to assess
what affects does pulmonary hypertension have on vessels & heart?
increases afterload of R- increases tension of the R side of heart has to work against, increases pulmonary vas resistance
what is pulse paradoxus?
when there is a decrease in systemic BP greater than 10mml of mercury during inspiration
what are causes of pulse paradoxus?
fluxuation of systolic BP during inspiration only, patient needs Aline cath for continuous monitoring,
caused by lung disease, see it in end stage heart failure
pulse paradoxus has what effects of pressures on surface of heart?
intrathoracic pressure, pericardial pressure, lung volumes around the heart
PPV information: positive pressure ventilation
-how does it effect the heart? decreases venous return, makes it harder for blood to return to the R atrium
-If venous return amount is decreased so will CO.
-causes pleural pressure to be more positive
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