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FCCN II: cardiac concepts
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FCCN II: cardiac concepts
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FCCN II: cardiac conceptspreload: what - -how wet/dry you are
amount of fluid filling heart
*affected by dilating/constricting VEINS*
R heart
-CVP
L heart
-PCWP (wedge pressure)
-preload: affected by - -VEINS
constrict --> INCREASE
dilate --> DECREASE
-preload: frank-starling principle - -giving fluid improves CO up to a certain
pt
-preload: Tx low - --*crystalloids*
-colloids: albumin, hespan
-blood: PRBCs, plasma
-preload: Tx high - --diuretics: lasix
-vasodilators: NTG, narector
-dialysis: hemodialysis
-afterload: what - -resistance to heart ejecting blood
L heart: systemic vascular resistance
*body = SVR*
R heart: pulmonary vascular resistance
*lungs = PVR*
-afterload: affected by - -ARTERIES
constrict --> INCREASE
dilate --> DECREASE
-afterload: Tx low - -*CONSTRICT ARTERIES*
-dopamine
-norepinephrine
, -phenylephrine
-afterload: Tx high - -*DILATE ARTERIES*
L heart (SVR)
-nipride
-ACE inhibitors
-ARBs
-apresoline
R heart (PVR)
-sildenafil
-milrinone
-isuprel
-nitric oxide
-afterload: causes high - -L heart afterload
-HF
-dehydration
-HTN
R heart afterload
-cor pulmonale
-sepsis
-afterload: causes low - -*ARTERIES DILATED*
-sepsis
-contractility: Rx to increase
*contractility = cardiac output* - --epinephrine 0.03-1.0 mcg/kg/min
-milrinone 0.375-0.75 mcg/kg/min
-dopamine 5-10 mcg/kg/min
-dobutamine 2-20 mcg/kg/min
-MAP: equation - -MAP = CO x resistance
-only give vasopressors to Tx... - -*DILATION*
-O2 delivery: what affects - -*Hgb x CO*
O2 load onto Hgb in lungs --> delivered to tissue via CO
*cardiac output = SV x HR*
*SV = preload | afterload | contractility*
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