Ed's Cardiac Output Lecture / Final Exam Prep

Question 1

Cardiac Output

Formula ?

Answer 1

C.O      =  HR           X   SV
ml/min = beats/min X ml/beat

Question 2

Cardiac Output (resting range)

Answer 2

4 - 8 L/m

Question 3

6 Factors affecting Cardiac Output

MOBGAP

Answer 3

• Metabolic rate
• Oxygen demand
• Body size / type
• Gender
• Age
• Posture

Question 4

The most potent determinate of cardiac output is

Answer 4

metabolic oxygen demand

Question 5

5 Things that increase metabolism:

Answer 5

• exercise
• sepsis
• strong emotion
• trauma/surgery
• temperature

Question 6

C.O. of a female Vs. C.O. of a male?

Answer 6

female = 10% lower than a male of the same body size

Question 7

In general, females have ____ skeletal muscle mass than males.

Answer 7

Smaller

Question 8

How do we adjust for individual differences??

Answer 8

• Calculate cardiac index!
• Adjusts C.O. to a
  defined measurement
  Of body tissue
  (BSA)

Question 9

Cardiac Index formula ?

Answer 9

C.O. / BSA

Question 10

Normal adult C.I. range?

Answer 10

2.5 - 4.2 L/min/m2

Question 11

How do we calculate BSA??

Answer 11

(w^.425)(H^.725)(.007184)

Question 12

Advantages of CI ?

Answer 12

Normalizes cardiac output relative to body surface area

Question 13

Disadvantages of CI ?

Answer 13

The relationship of metabolism to surface area can be very different from patient to patient

Question 14

When is CI at its highest?

Answer 14

Childhood

Question 15

Neonates may have

Answer 15

X3 the CI as an adult

Question 16

when a person stands up, what happen?

Answer 16

C.O. decreases

Question 17

S.V. formula =

Answer 17

C.O. / HR X1000

Question 18

DO2 (delivery) formula=

Answer 18

CaO2 X C.O. X 10

Question 19

PVR formula =

Answer 19

80 X (MPAP-PAWP) /C.O.

Question 20

SVR formula =

Answer 20

80 X (MAP - RAP) / C.O.

Question 21

Stroke volume is a function of:

Answer 21

A. Preload (EDP)
B. Afterload (Pa)
C. Contractility

Question 22

Normal S.V. =

Answer 22

60 - 100 ml/beat

Question 23

E.F. Formula =

Answer 23

S.V. X 100 / EDV

Question 24

Normal E.F. =

Answer 24

65%

Question 25

Frank-Starling Law | describes what?

Answer 25

relationship between SV and cardiac performance

Question 26

Preload definition = LVEDP y = Press X = Volume

Answer 26

``` the amount of -myocardial fiber stretch &/or - amount of volume in the ventricle at the end of diastole ```

Question 27

Afterload definition =

Answer 27

resistance, impedance, pressure the ventricles must overcome | To eject its blood volume

Question 28

Clinically the most sensitive measure of afterload is ?

Answer 28

SVR/PVR

Question 29

SVR formula =

Answer 29

(MAP-RAP) X 80 _________________ C.O.

Question 30

PVR formula =

Answer 30

(MPAP - PAWP) X 80 _________________ C.O.

Question 31

What has an inverse relationship to afterload ?

Answer 31

Afterload

Question 32

Inotrophism definition ?

Answer 32

inherent property of shortening of the myocardial | muscle fibers, apart from preload

Question 33

What pathologies invalidate that the RV C.O. and LV C.O. are equal ?

Answer 33

- Intra-cardiac shunts | - Reguritant lesions

Question 34

3 Invasive techniques to measure C.O. ?

Answer 34

Fick Method Dye dilution Thermal dilution

Question 35

2 Non Invasive techniques to measure C.O. ?

Answer 35

Doppler | Bioimpedance

Question 36

3 requirements for the Fick Principle?

Answer 36

- Arterial sample - Mixed venous sample - Spirometer

Question 37

Fick Principle measures what ?

Answer 37

1. total O2 uptake per minute 2. amount into each 100 cc blood

Question 38

The Fick method for cardiac output determination equation ?

Answer 38

C.O. (Q) = VO2 ____________ CaO2 - CvO2 X 10

Question 39

“Gold standard” for measuring CO is ?

Answer 39

Thermodilution

Question 40

What are the two methods of thermodilution that are available:

Answer 40

1) bolus thermodilution | 2) continuous cardiac output (CCO)

Question 41

Catheter in the pulmonary artery monitors change in temperature of passing blood after a bolus of room temperature saline is deposited into the right atrium.

Answer 41

Thermodilution Method

Question 42

In thermodilution process, the injectate port should be in ?

Answer 42

``` SVC or IVC or RA ```

Question 43

In thermodilution process, the thermistor to monitor the blood's temperature is located near the catheter's distal tip, which should lie in ?

Answer 43

PA

Question 44

to calculate the area beneath the curve. This area is | inversely proportional to what ?

Answer 44

C.O.

Question 45

Small area under the curve =

Answer 45

higher C.O.

Question 46

Large area under the curve =

Answer 46

lower C.O.

Question 47

In bolus thermodilution, the CO curve is | displayed on the monitor and validates

Answer 47

Correct Injection technique

Question 48

The accuracy of the thermodilution method depends on several assumptions:

Answer 48

1) Blood and injectant have mixed adequately. 2) Blood flow is forward. 3) Baseline temperature in the PA is steady. 4) Appropriate technique is used.