SlideShare a Scribd company logo
1 of 31
DR NILESH KATE
MBBS,MD
ASSOCIATE PROF
DEPT. OF PHYSIOLOGY
CARDIAC
OUTPUT - I
OBJECTIVES
 Definition.
 Measurement of cardiac
output.
 Variations in cardiac output.
 Regulation of cardiac output.
 Heart lung preparation.
 Cardiac & vascular function
curves.
Thursday, February 4, 2016
Some Facts………
 Is about 4.8 inches tall and 3.35 inches wide
 Weighs about .68 lb. in men and .56 lb. in women
 Beats about 100,000 times per day
 Beats 2.5 billion time in an average 70 yr. lifetime
 Pumps about 2000 gallons of blood each day
 Circulates blood completely 1000 times each day
 Pumps blood through 62,000 miles of vessels
 Suffers 7.2 mil. CAD deaths worldwide each year
Thursday, February 4, 2016
DEFINITION.
 Amount of blood
ejected by each
ventricle per minute.
 CO = SV * HR…..
 SV – Stroke Volume.
 HR – Heart rate.
 Cardiac output
 80 * 70 = 5.6 L/min.
Thursday, February 4, 2016
SIGNIFICANCE
 It’s the cardiac output
that decides the rate of
blood flow to the
different parts of the
body.
 Decrease in cardiac
output
 Decrease in blood flow
Thursday, February 4, 2016
RELATIONSHIP OF CARDIAC
OUTPUT & VENOUS RETURN
 VENOUS RETURN
 It is the quantity of
blood returned from all
over the body through
the veins into the right
atrium each minute
 Venous return = cardiac
output
Thursday, February 4, 2016
Components…….
 Stroke volume
 Amount of blood
pumped by each
ventricle per beat or per
contraction.
 80 ml.
 Stroke volume
depends on –
 End diastolic volume
 contractility
Thursday, February 4, 2016
Components…….
 Heart rate
 Under normal
circumstances 70
times/min.
 Increase in heart rate
increases Cardiac
output… but upto limit
 After it decreases due
to decrease in Cardiac
filling.
Thursday, February 4, 2016
MINUTE VOLUME
It is the amount of
blood pumped out
by each ventricle per
minute.
MINUTE VOLUME =
Stroke volume x HR
Normal value:
5litres/ventricle/minut
e.
Thursday, February 4, 2016
CARDIAC INDEX.
 Cardiac output
is the amount of blood
pumped out per ventricle
per minute per square
meter of body surface area.
 Expressed in relation to the
body surface area.
 Normal value –
3.2L/min/m2
Thursday, February 4, 2016
CARDIAC RESERVE.
 Maximum increase in
the cardiac output
above the normal value.
 Expressed in
Percentage.
 Normal values.
 Adults – 300-400%
 Old age – 200-250%
 Athletes – 500-600%
 Variations
 Maximum – Heavy
exercise.
 Minimum – Cardiac
diseases.
Thursday, February 4, 2016
MEASUREMENT OF CARDIAC
OUTPUT.
 Methods based on Fick’s
principle
 Indicator or dye dilution
method.
 Thermodilution
 Inhalation of inert gases.
 Physical methods
 Doppler echocardiography.
 Ballistocardiography.
 Cineradiographic technique.
Thursday, February 4, 2016
METHODS BASED ON FICK’S
PRINCIPLE
 Fick’s principle –
Amount of substance
taken up by an organ
per unit of time (Q) is
equal to the arterial
level of the substance
(A) – venous level of
substance (V) × Blood
flow(F)
 Q = (A-V) F
 F = Q
-------
(A-V)
 2 methods
 Direct
 Indirect
Thursday, February 4, 2016
METHODS BASED ON FICK’S
PRINCIPLE
Thursday, February 4, 2016
DIRECT METHOD.
 Principle – pulmonary
blood flow = Rt
ventricular blood flow = Lt
ventricular blood flow.
 Pulmonary blood flow =
amount of O2 taken by
lungs
-------------------------------
PVO2-PAO2
 Amount of O2 taken
determined by
spirometer.
 PVO2 – from any
peripheral artery
 PAO2 – from
pulmonary artery.
Thursday, February 4, 2016
DIRECT METHOD.
 Pulmonary blood flow =
amount of O2 taken by
lungs
-------------------------------
PVO2-PAO2
 CO = 2000/ (200-160) ×
100
 CO = 5000ml/min
 Disadvantages.
 Invasive, risk of
infection &
hemorrhage.
 Pt is conscious so CO is
more than normal
 Complications –
ventricular
fibrillations.
Thursday, February 4, 2016
DIRECT METHOD.
Thursday, February 4, 2016
INDIRECT METHOD.
 Same as direct
method only
 CO2 excretion by lungs
is measured by
spirometry.
 PACO2 from alveolar
air.
 PVCO2 – Rebreathing
into closed bag.
 CO = CO2 output/min
----------------------
PACO2-PVCO2
Thursday, February 4, 2016
INDICATOR OR DYE DILUTION
METHOD.
 Principle – Known
amount of dye injected
into Rt atrium & mean
concentration of its
first passage through
an artery is
determined.
 Blood flow (F)= Q/Ct
 F = blood flow in
L/min.
 Q= quantity of dye
injected.
 C = Mean Conc. of dye.
 T = Time duration in
sec of first passage of
dye.
Thursday, February 4, 2016
IDEAL INDICATOR.
 Should be nontoxic.
 Mix evenly.
 Easy to measure.
 Not alter cardiac output
or haemodynamic.
 Not be changed by
body.
 E.g. Evan’s blue,
radioactive isotopes.
Thursday, February 4, 2016
PROCEDURE.
 5 mg of Evan’s blue dye
mixed with venous blood.
 Duration of first passage
of dye(t) & mean conc of
dye (C) in arterial blood
estimated.
 CO= Q/ct × 60 = 5/1.5L
×40 × 60 = 5 L/min
Thursday, February 4, 2016
THERMODILUTION
 PRINCIPLE – same as
indicator dye dilution
method except cold
saline is used.
 Resultant change in
blood temperature in
pulmonary artery is
determined.
Thursday, February 4, 2016
INHALATION OF INERT GASES.
 NO, Acetylene – used.
 Pulmonary blood flow
is determined from
following values
 Quantity of gas
absorbed in given time.
 Partial pressure of gas
in alveolar air.
 The solubility of gas.
Thursday, February 4, 2016
PHYSICAL METHODS
 Doppler
echocardiography –
 Ultrasonic evaluations
of cardiac functions.
 B-scan ultrasound at a
frequency of 2.25 MHz
using a transducer.
 Measure EDV, ESV,CO
& Valvular defects.
Thursday, February 4, 2016
Thursday, February 4, 2016
PHYSICAL METHODS
 Ballistocardiography
 Graphical record of the
pulsations created due
to ballistic recoil of the
pumping heart.
Thursday, February 4, 2016
PHYSICAL METHODS
 CINERADIOGRAPHIC
TECHNIQUE.
 The making of a motion
picture record of successive
images appearing on a
fluoroscopic screen.
 Radiography of an organ in
motion, for example, the
heart, the gastrointestinal
tract.
Thursday, February 4, 2016
VARIATIONS IN CARDIAC
OUTPUT.
 Physiological causes.
 Age – CI children >
adult.
 Sex – females > Males
 Diurnal variations-
low in early morning.
 Environmental
temperature – direct
relation.
 Anxiety excitement,
Eating, Exercise,
Pregnancy, High
altitude – direct
relation.
 Posture change –
sitting or standing >
lying down due to
venous pooling.
Thursday, February 4, 2016
VARIATIONS IN CARDIAC
OUTPUT.
 Pathological – its
mainly due to low
peripheral resistance
 Increase
 Fever
 Anemia.
 Hyperthyroidism.
 Beriberi
 Arteriovenous fistula
Thursday, February 4, 2016
VARIATIONS IN CARDIAC
OUTPUT.
 Decrease
 CCF
 Rapid arrhythmias
 Cardiac shock
 Incomplete heart block
 Hemorrhage
 Hypothyroidism.
Thursday, February 4, 2016
Thank you.
Thursday, February 4, 2016

More Related Content

What's hot (20)

cardiovascular physiology
 cardiovascular physiology cardiovascular physiology
cardiovascular physiology
 
Cardiac cycle
Cardiac cycleCardiac cycle
Cardiac cycle
 
Hypoxia
HypoxiaHypoxia
Hypoxia
 
CORONARY CIRCULATION
CORONARY CIRCULATIONCORONARY CIRCULATION
CORONARY CIRCULATION
 
Blood pressure & its regulation
Blood pressure & its regulationBlood pressure & its regulation
Blood pressure & its regulation
 
Blood pressure
Blood pressure Blood pressure
Blood pressure
 
Blood supply of heart
Blood supply of heartBlood supply of heart
Blood supply of heart
 
Regulation of blood pressure
Regulation of blood pressureRegulation of blood pressure
Regulation of blood pressure
 
The heart chambers
The heart chambersThe heart chambers
The heart chambers
 
Cardiac muscle physiology
Cardiac muscle physiologyCardiac muscle physiology
Cardiac muscle physiology
 
Heart rate by pandian m
Heart rate by pandian mHeart rate by pandian m
Heart rate by pandian m
 
NEUROMUSCULAR JUNCTION
NEUROMUSCULAR JUNCTIONNEUROMUSCULAR JUNCTION
NEUROMUSCULAR JUNCTION
 
Physiology of gas exchange
Physiology of gas exchangePhysiology of gas exchange
Physiology of gas exchange
 
The coronary circulation
The coronary circulationThe coronary circulation
The coronary circulation
 
Cardiac Cycle.pptx
Cardiac Cycle.pptxCardiac Cycle.pptx
Cardiac Cycle.pptx
 
TRANPORT OF OXYGEN
TRANPORT OF OXYGENTRANPORT OF OXYGEN
TRANPORT OF OXYGEN
 
Cardiac cycle
Cardiac cycle   Cardiac cycle
Cardiac cycle
 
Neural regulation of Respiration
Neural regulation of RespirationNeural regulation of Respiration
Neural regulation of Respiration
 
Pulmonary circulation
Pulmonary circulationPulmonary circulation
Pulmonary circulation
 
Valves of heart
Valves of heartValves of heart
Valves of heart
 

Viewers also liked

Cardiac output
Cardiac outputCardiac output
Cardiac outputatsmp
 
#Cardiac output, venous return,and their regulation
#Cardiac output, venous return,and their regulation#Cardiac output, venous return,and their regulation
#Cardiac output, venous return,and their regulationLubna Abu Alrub,DDS
 
Cardiac output monitoring
Cardiac output monitoringCardiac output monitoring
Cardiac output monitoringNIICS
 
Cardiac output, blood flow, and blood pressure
Cardiac output, blood flow, and blood pressureCardiac output, blood flow, and blood pressure
Cardiac output, blood flow, and blood pressureChy Yong
 
Determinants of cardiac output for captivate
Determinants of cardiac output for captivateDeterminants of cardiac output for captivate
Determinants of cardiac output for captivateleslielally
 
regulation of cardiac out put
regulation of cardiac out putregulation of cardiac out put
regulation of cardiac out putrobel abay
 
Cardiac output and venous return
Cardiac output and venous returnCardiac output and venous return
Cardiac output and venous returnErhard Rutashobya
 
TISSUE AND GLANDS BASIC
TISSUE AND GLANDS BASICTISSUE AND GLANDS BASIC
TISSUE AND GLANDS BASICDr Nilesh Kate
 
PULMONARY FUNCTION TESTS
PULMONARY FUNCTION TESTSPULMONARY FUNCTION TESTS
PULMONARY FUNCTION TESTSDr Nilesh Kate
 
MOTOR SYSTEM SPINAL CORD
MOTOR SYSTEM SPINAL CORDMOTOR SYSTEM SPINAL CORD
MOTOR SYSTEM SPINAL CORDDr Nilesh Kate
 
Glucagon - REGULATION OF BLOOD GLUCOSE
Glucagon - REGULATION OF BLOOD GLUCOSEGlucagon - REGULATION OF BLOOD GLUCOSE
Glucagon - REGULATION OF BLOOD GLUCOSEDr Nilesh Kate
 
ADRENAL CORTEX AND GLUCOCORTICOIDS
ADRENAL CORTEX AND GLUCOCORTICOIDSADRENAL CORTEX AND GLUCOCORTICOIDS
ADRENAL CORTEX AND GLUCOCORTICOIDSDr Nilesh Kate
 

Viewers also liked (20)

Cardiac output
Cardiac outputCardiac output
Cardiac output
 
Cardiac output 2
Cardiac output 2Cardiac output 2
Cardiac output 2
 
Cardiac output 2
Cardiac output 2Cardiac output 2
Cardiac output 2
 
#Cardiac output, venous return,and their regulation
#Cardiac output, venous return,and their regulation#Cardiac output, venous return,and their regulation
#Cardiac output, venous return,and their regulation
 
Cardiac output monitoring
Cardiac output monitoringCardiac output monitoring
Cardiac output monitoring
 
Cardiac output, blood flow, and blood pressure
Cardiac output, blood flow, and blood pressureCardiac output, blood flow, and blood pressure
Cardiac output, blood flow, and blood pressure
 
Determinants of cardiac output for captivate
Determinants of cardiac output for captivateDeterminants of cardiac output for captivate
Determinants of cardiac output for captivate
 
regulation of cardiac out put
regulation of cardiac out putregulation of cardiac out put
regulation of cardiac out put
 
Cardiac output and venous return
Cardiac output and venous returnCardiac output and venous return
Cardiac output and venous return
 
TUBULAR REABSORPTION
TUBULAR REABSORPTIONTUBULAR REABSORPTION
TUBULAR REABSORPTION
 
BLOOD VOLUME
BLOOD VOLUMEBLOOD VOLUME
BLOOD VOLUME
 
Physiology of Heart
Physiology of HeartPhysiology of Heart
Physiology of Heart
 
MUSCLE CIRCULATION
MUSCLE CIRCULATIONMUSCLE CIRCULATION
MUSCLE CIRCULATION
 
TISSUE AND GLANDS BASIC
TISSUE AND GLANDS BASICTISSUE AND GLANDS BASIC
TISSUE AND GLANDS BASIC
 
INSULIN
INSULININSULIN
INSULIN
 
PULMONARY FUNCTION TESTS
PULMONARY FUNCTION TESTSPULMONARY FUNCTION TESTS
PULMONARY FUNCTION TESTS
 
MOTOR SYSTEM SPINAL CORD
MOTOR SYSTEM SPINAL CORDMOTOR SYSTEM SPINAL CORD
MOTOR SYSTEM SPINAL CORD
 
Glucagon - REGULATION OF BLOOD GLUCOSE
Glucagon - REGULATION OF BLOOD GLUCOSEGlucagon - REGULATION OF BLOOD GLUCOSE
Glucagon - REGULATION OF BLOOD GLUCOSE
 
CEREBRAL CORTEX
CEREBRAL CORTEXCEREBRAL CORTEX
CEREBRAL CORTEX
 
ADRENAL CORTEX AND GLUCOCORTICOIDS
ADRENAL CORTEX AND GLUCOCORTICOIDSADRENAL CORTEX AND GLUCOCORTICOIDS
ADRENAL CORTEX AND GLUCOCORTICOIDS
 

Similar to Cardiac output 1

cardiacoutput1-160204135018 (1).pptx
cardiacoutput1-160204135018 (1).pptxcardiacoutput1-160204135018 (1).pptx
cardiacoutput1-160204135018 (1).pptxMSrujanaDevi
 
Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...
Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...
Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...Physiology Dept
 
Cardiac out put and its regulation
Cardiac out put and its regulationCardiac out put and its regulation
Cardiac out put and its regulationRaghu Veer
 
MEASUREMENT OF CARDIAC OUTPUT
MEASUREMENT OF CARDIAC OUTPUTMEASUREMENT OF CARDIAC OUTPUT
MEASUREMENT OF CARDIAC OUTPUTAmudhaLakshmi1
 
Pulse & hypertension
Pulse & hypertensionPulse & hypertension
Pulse & hypertensionSravan Kumar
 
Bedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenationBedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenationDr. Tushar Patil
 
cardiac output monitoring
cardiac output monitoringcardiac output monitoring
cardiac output monitoringmadhu chaitanya
 
Monitoring Modality in anesthesia
Monitoring Modality  in anesthesiaMonitoring Modality  in anesthesia
Monitoring Modality in anesthesiaDr.RMLIMS lucknow
 
4. cardiovascular delfin
4.  cardiovascular delfin4.  cardiovascular delfin
4. cardiovascular delfinshenell delfin
 
Insight into Monitoring of the surgical patient
Insight into Monitoring of the surgical patientInsight into Monitoring of the surgical patient
Insight into Monitoring of the surgical patientlmdm11
 
Hemodynamic monitoring in ICU
Hemodynamic monitoring in ICUHemodynamic monitoring in ICU
Hemodynamic monitoring in ICUManoj Prabhakar
 
Recording of arterial blood pressure and Special circulation
Recording of arterial blood pressure and Special circulationRecording of arterial blood pressure and Special circulation
Recording of arterial blood pressure and Special circulationkamla13
 
cardiac output measurment and monitoring ppt-1.pptx
cardiac output measurment and monitoring ppt-1.pptxcardiac output measurment and monitoring ppt-1.pptx
cardiac output measurment and monitoring ppt-1.pptxshekinah41
 
Hemodynamics - Putting the puzzle together
Hemodynamics - Putting the puzzle togetherHemodynamics - Putting the puzzle together
Hemodynamics - Putting the puzzle togetherUscom - Presentations
 
Cardio-Pulmonary Changes during Exercise
Cardio-Pulmonary Changes during ExerciseCardio-Pulmonary Changes during Exercise
Cardio-Pulmonary Changes during ExerciseShazeena Qaiser
 

Similar to Cardiac output 1 (20)

cardiacoutput1-160204135018 (1).pptx
cardiacoutput1-160204135018 (1).pptxcardiacoutput1-160204135018 (1).pptx
cardiacoutput1-160204135018 (1).pptx
 
Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...
Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...
Cardiac output by Dr. Amruta Nitin Kumbhar Assistant Professor, Dept. of Phys...
 
Cardiac out put and its regulation
Cardiac out put and its regulationCardiac out put and its regulation
Cardiac out put and its regulation
 
Cardiac Output
Cardiac Output Cardiac Output
Cardiac Output
 
MEASUREMENT OF CARDIAC OUTPUT
MEASUREMENT OF CARDIAC OUTPUTMEASUREMENT OF CARDIAC OUTPUT
MEASUREMENT OF CARDIAC OUTPUT
 
Pulse & hypertension
Pulse & hypertensionPulse & hypertension
Pulse & hypertension
 
Bedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenationBedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenation
 
cardiac output monitoring
cardiac output monitoringcardiac output monitoring
cardiac output monitoring
 
Monitoring Modality in anesthesia
Monitoring Modality  in anesthesiaMonitoring Modality  in anesthesia
Monitoring Modality in anesthesia
 
4. cardiovascular delfin
4.  cardiovascular delfin4.  cardiovascular delfin
4. cardiovascular delfin
 
Insight into Monitoring of the surgical patient
Insight into Monitoring of the surgical patientInsight into Monitoring of the surgical patient
Insight into Monitoring of the surgical patient
 
Hemodynamic monitoring in ICU
Hemodynamic monitoring in ICUHemodynamic monitoring in ICU
Hemodynamic monitoring in ICU
 
Bp pulse and cardiac output
Bp pulse and cardiac outputBp pulse and cardiac output
Bp pulse and cardiac output
 
Recording of arterial blood pressure and Special circulation
Recording of arterial blood pressure and Special circulationRecording of arterial blood pressure and Special circulation
Recording of arterial blood pressure and Special circulation
 
cardiac output measurment and monitoring ppt-1.pptx
cardiac output measurment and monitoring ppt-1.pptxcardiac output measurment and monitoring ppt-1.pptx
cardiac output measurment and monitoring ppt-1.pptx
 
ABG test
ABG testABG test
ABG test
 
Hemodynamics - Putting the puzzle together
Hemodynamics - Putting the puzzle togetherHemodynamics - Putting the puzzle together
Hemodynamics - Putting the puzzle together
 
Cardio-Pulmonary Changes during Exercise
Cardio-Pulmonary Changes during ExerciseCardio-Pulmonary Changes during Exercise
Cardio-Pulmonary Changes during Exercise
 
Cardiac tamponade
Cardiac tamponadeCardiac tamponade
Cardiac tamponade
 
cardiac output.pptx
cardiac output.pptxcardiac output.pptx
cardiac output.pptx
 

More from Dr Nilesh Kate

RESPIRATORY PHYSIOLOGY INTRODUCTION
RESPIRATORY PHYSIOLOGY INTRODUCTIONRESPIRATORY PHYSIOLOGY INTRODUCTION
RESPIRATORY PHYSIOLOGY INTRODUCTIONDr Nilesh Kate
 
NERVE GROWTH FACTORS, NEUROTROPHINS
NERVE GROWTH FACTORS, NEUROTROPHINSNERVE GROWTH FACTORS, NEUROTROPHINS
NERVE GROWTH FACTORS, NEUROTROPHINSDr Nilesh Kate
 
CELL JUNCTIONS AND CYTOSKELETON
CELL JUNCTIONS AND CYTOSKELETONCELL JUNCTIONS AND CYTOSKELETON
CELL JUNCTIONS AND CYTOSKELETONDr Nilesh Kate
 
GASTRIC FUNCTION TESTS
GASTRIC FUNCTION TESTSGASTRIC FUNCTION TESTS
GASTRIC FUNCTION TESTSDr Nilesh Kate
 
ENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTION
ENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTIONENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTION
ENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTIONDr Nilesh Kate
 
Functional anatomy and physiology of cardiac muscle
Functional anatomy and physiology of cardiac muscleFunctional anatomy and physiology of cardiac muscle
Functional anatomy and physiology of cardiac muscleDr Nilesh Kate
 
Disturbances of respiration
Disturbances of respirationDisturbances of respiration
Disturbances of respirationDr Nilesh Kate
 
Sexual growth and development
Sexual growth and developmentSexual growth and development
Sexual growth and developmentDr Nilesh Kate
 
Physiology of pregnancy
Physiology of pregnancyPhysiology of pregnancy
Physiology of pregnancyDr Nilesh Kate
 

More from Dr Nilesh Kate (20)

RESPIRATORY PHYSIOLOGY INTRODUCTION
RESPIRATORY PHYSIOLOGY INTRODUCTIONRESPIRATORY PHYSIOLOGY INTRODUCTION
RESPIRATORY PHYSIOLOGY INTRODUCTION
 
TRANSPORT OF OXYGEN
TRANSPORT OF OXYGENTRANSPORT OF OXYGEN
TRANSPORT OF OXYGEN
 
ELECTROMYOGRAPHY
ELECTROMYOGRAPHYELECTROMYOGRAPHY
ELECTROMYOGRAPHY
 
NERVE GROWTH FACTORS, NEUROTROPHINS
NERVE GROWTH FACTORS, NEUROTROPHINSNERVE GROWTH FACTORS, NEUROTROPHINS
NERVE GROWTH FACTORS, NEUROTROPHINS
 
CELL JUNCTIONS AND CYTOSKELETON
CELL JUNCTIONS AND CYTOSKELETONCELL JUNCTIONS AND CYTOSKELETON
CELL JUNCTIONS AND CYTOSKELETON
 
TISSUE-GLANDS
 TISSUE-GLANDS TISSUE-GLANDS
TISSUE-GLANDS
 
CELL JUNCTIONS.pptx
CELL JUNCTIONS.pptxCELL JUNCTIONS.pptx
CELL JUNCTIONS.pptx
 
Compliance of lung
Compliance of lungCompliance of lung
Compliance of lung
 
Compliance of lung
Compliance of lungCompliance of lung
Compliance of lung
 
GASTRIC FUNCTION TESTS
GASTRIC FUNCTION TESTSGASTRIC FUNCTION TESTS
GASTRIC FUNCTION TESTS
 
GENETICS
GENETICSGENETICS
GENETICS
 
ENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTION
ENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTIONENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTION
ENERGY SOURCE AND THERMAL CHANGES IN MUSCLE CONTRACTION
 
Functional anatomy and physiology of cardiac muscle
Functional anatomy and physiology of cardiac muscleFunctional anatomy and physiology of cardiac muscle
Functional anatomy and physiology of cardiac muscle
 
Disturbances of respiration
Disturbances of respirationDisturbances of respiration
Disturbances of respiration
 
Vestibular apparatus
Vestibular apparatusVestibular apparatus
Vestibular apparatus
 
Skin
SkinSkin
Skin
 
Sexual growth and development
Sexual growth and developmentSexual growth and development
Sexual growth and development
 
Semen analysis
Semen analysisSemen analysis
Semen analysis
 
Renal hormones
Renal hormonesRenal hormones
Renal hormones
 
Physiology of pregnancy
Physiology of pregnancyPhysiology of pregnancy
Physiology of pregnancy
 

Recently uploaded

ABO Blood grouping in-compatibility in pregnancy
ABO Blood grouping in-compatibility in pregnancyABO Blood grouping in-compatibility in pregnancy
ABO Blood grouping in-compatibility in pregnancyMs. Sapna Pal
 
Dr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdf
Dr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdfDr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdf
Dr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdfSumathi Arumugam
 
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...Halo Docter
 
HISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptx
HISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptxHISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptx
HISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptxDhanashri Prakash Sonavane
 
Top 10 Most Beautiful Chinese Pornstars List 2024
Top 10 Most Beautiful Chinese Pornstars List 2024Top 10 Most Beautiful Chinese Pornstars List 2024
Top 10 Most Beautiful Chinese Pornstars List 2024locantocallgirl01
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxSwetaba Besh
 
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...bkling
 
Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024locantocallgirl01
 
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...rightmanforbloodline
 
Physiologic Anatomy of Heart_AntiCopy.pdf
Physiologic Anatomy of Heart_AntiCopy.pdfPhysiologic Anatomy of Heart_AntiCopy.pdf
Physiologic Anatomy of Heart_AntiCopy.pdfMedicoseAcademics
 
VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...
VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...
VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...deepakkumar115120
 
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...rightmanforbloodline
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesMedicoseAcademics
 
Face and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxFace and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxDr. Rabia Inam Gandapore
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana GuptaLifecare Centre
 
Intro to disinformation and public health
Intro to disinformation and public healthIntro to disinformation and public health
Intro to disinformation and public healthTina Purnat
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxSwetaba Besh
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsMedicoseAcademics
 
MOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATRO
MOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATROMOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATRO
MOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATROKanhu Charan
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan 087776558899
 

Recently uploaded (20)

ABO Blood grouping in-compatibility in pregnancy
ABO Blood grouping in-compatibility in pregnancyABO Blood grouping in-compatibility in pregnancy
ABO Blood grouping in-compatibility in pregnancy
 
Dr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdf
Dr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdfDr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdf
Dr. A Sumathi - LINEARITY CONCEPT OF SIGNIFICANCE.pdf
 
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...
 
HISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptx
HISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptxHISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptx
HISTORY, CONCEPT AND ITS IMPORTANCE IN DRUG DEVELOPMENT.pptx
 
Top 10 Most Beautiful Chinese Pornstars List 2024
Top 10 Most Beautiful Chinese Pornstars List 2024Top 10 Most Beautiful Chinese Pornstars List 2024
Top 10 Most Beautiful Chinese Pornstars List 2024
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...
See it and Catch it! Recognizing the Thought Traps that Negatively Impact How...
 
Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024
 
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
 
Physiologic Anatomy of Heart_AntiCopy.pdf
Physiologic Anatomy of Heart_AntiCopy.pdfPhysiologic Anatomy of Heart_AntiCopy.pdf
Physiologic Anatomy of Heart_AntiCopy.pdf
 
VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...
VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...
VIP ℂall Girls Arekere Bangalore 6378878445 WhatsApp: Me All Time Serviℂe Ava...
 
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
 
Face and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxFace and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptx
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Intro to disinformation and public health
Intro to disinformation and public healthIntro to disinformation and public health
Intro to disinformation and public health
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
 
MOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATRO
MOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATROMOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATRO
MOTION MANAGEMANT IN LUNG SBRT BY DR KANHU CHARAN PATRO
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 

Cardiac output 1

  • 1. DR NILESH KATE MBBS,MD ASSOCIATE PROF DEPT. OF PHYSIOLOGY CARDIAC OUTPUT - I
  • 2. OBJECTIVES  Definition.  Measurement of cardiac output.  Variations in cardiac output.  Regulation of cardiac output.  Heart lung preparation.  Cardiac & vascular function curves. Thursday, February 4, 2016
  • 3. Some Facts………  Is about 4.8 inches tall and 3.35 inches wide  Weighs about .68 lb. in men and .56 lb. in women  Beats about 100,000 times per day  Beats 2.5 billion time in an average 70 yr. lifetime  Pumps about 2000 gallons of blood each day  Circulates blood completely 1000 times each day  Pumps blood through 62,000 miles of vessels  Suffers 7.2 mil. CAD deaths worldwide each year Thursday, February 4, 2016
  • 4. DEFINITION.  Amount of blood ejected by each ventricle per minute.  CO = SV * HR…..  SV – Stroke Volume.  HR – Heart rate.  Cardiac output  80 * 70 = 5.6 L/min. Thursday, February 4, 2016
  • 5. SIGNIFICANCE  It’s the cardiac output that decides the rate of blood flow to the different parts of the body.  Decrease in cardiac output  Decrease in blood flow Thursday, February 4, 2016
  • 6. RELATIONSHIP OF CARDIAC OUTPUT & VENOUS RETURN  VENOUS RETURN  It is the quantity of blood returned from all over the body through the veins into the right atrium each minute  Venous return = cardiac output Thursday, February 4, 2016
  • 7. Components…….  Stroke volume  Amount of blood pumped by each ventricle per beat or per contraction.  80 ml.  Stroke volume depends on –  End diastolic volume  contractility Thursday, February 4, 2016
  • 8. Components…….  Heart rate  Under normal circumstances 70 times/min.  Increase in heart rate increases Cardiac output… but upto limit  After it decreases due to decrease in Cardiac filling. Thursday, February 4, 2016
  • 9. MINUTE VOLUME It is the amount of blood pumped out by each ventricle per minute. MINUTE VOLUME = Stroke volume x HR Normal value: 5litres/ventricle/minut e. Thursday, February 4, 2016
  • 10. CARDIAC INDEX.  Cardiac output is the amount of blood pumped out per ventricle per minute per square meter of body surface area.  Expressed in relation to the body surface area.  Normal value – 3.2L/min/m2 Thursday, February 4, 2016
  • 11. CARDIAC RESERVE.  Maximum increase in the cardiac output above the normal value.  Expressed in Percentage.  Normal values.  Adults – 300-400%  Old age – 200-250%  Athletes – 500-600%  Variations  Maximum – Heavy exercise.  Minimum – Cardiac diseases. Thursday, February 4, 2016
  • 12. MEASUREMENT OF CARDIAC OUTPUT.  Methods based on Fick’s principle  Indicator or dye dilution method.  Thermodilution  Inhalation of inert gases.  Physical methods  Doppler echocardiography.  Ballistocardiography.  Cineradiographic technique. Thursday, February 4, 2016
  • 13. METHODS BASED ON FICK’S PRINCIPLE  Fick’s principle – Amount of substance taken up by an organ per unit of time (Q) is equal to the arterial level of the substance (A) – venous level of substance (V) × Blood flow(F)  Q = (A-V) F  F = Q ------- (A-V)  2 methods  Direct  Indirect Thursday, February 4, 2016
  • 14. METHODS BASED ON FICK’S PRINCIPLE Thursday, February 4, 2016
  • 15. DIRECT METHOD.  Principle – pulmonary blood flow = Rt ventricular blood flow = Lt ventricular blood flow.  Pulmonary blood flow = amount of O2 taken by lungs ------------------------------- PVO2-PAO2  Amount of O2 taken determined by spirometer.  PVO2 – from any peripheral artery  PAO2 – from pulmonary artery. Thursday, February 4, 2016
  • 16. DIRECT METHOD.  Pulmonary blood flow = amount of O2 taken by lungs ------------------------------- PVO2-PAO2  CO = 2000/ (200-160) × 100  CO = 5000ml/min  Disadvantages.  Invasive, risk of infection & hemorrhage.  Pt is conscious so CO is more than normal  Complications – ventricular fibrillations. Thursday, February 4, 2016
  • 18. INDIRECT METHOD.  Same as direct method only  CO2 excretion by lungs is measured by spirometry.  PACO2 from alveolar air.  PVCO2 – Rebreathing into closed bag.  CO = CO2 output/min ---------------------- PACO2-PVCO2 Thursday, February 4, 2016
  • 19. INDICATOR OR DYE DILUTION METHOD.  Principle – Known amount of dye injected into Rt atrium & mean concentration of its first passage through an artery is determined.  Blood flow (F)= Q/Ct  F = blood flow in L/min.  Q= quantity of dye injected.  C = Mean Conc. of dye.  T = Time duration in sec of first passage of dye. Thursday, February 4, 2016
  • 20. IDEAL INDICATOR.  Should be nontoxic.  Mix evenly.  Easy to measure.  Not alter cardiac output or haemodynamic.  Not be changed by body.  E.g. Evan’s blue, radioactive isotopes. Thursday, February 4, 2016
  • 21. PROCEDURE.  5 mg of Evan’s blue dye mixed with venous blood.  Duration of first passage of dye(t) & mean conc of dye (C) in arterial blood estimated.  CO= Q/ct × 60 = 5/1.5L ×40 × 60 = 5 L/min Thursday, February 4, 2016
  • 22. THERMODILUTION  PRINCIPLE – same as indicator dye dilution method except cold saline is used.  Resultant change in blood temperature in pulmonary artery is determined. Thursday, February 4, 2016
  • 23. INHALATION OF INERT GASES.  NO, Acetylene – used.  Pulmonary blood flow is determined from following values  Quantity of gas absorbed in given time.  Partial pressure of gas in alveolar air.  The solubility of gas. Thursday, February 4, 2016
  • 24. PHYSICAL METHODS  Doppler echocardiography –  Ultrasonic evaluations of cardiac functions.  B-scan ultrasound at a frequency of 2.25 MHz using a transducer.  Measure EDV, ESV,CO & Valvular defects. Thursday, February 4, 2016
  • 26. PHYSICAL METHODS  Ballistocardiography  Graphical record of the pulsations created due to ballistic recoil of the pumping heart. Thursday, February 4, 2016
  • 27. PHYSICAL METHODS  CINERADIOGRAPHIC TECHNIQUE.  The making of a motion picture record of successive images appearing on a fluoroscopic screen.  Radiography of an organ in motion, for example, the heart, the gastrointestinal tract. Thursday, February 4, 2016
  • 28. VARIATIONS IN CARDIAC OUTPUT.  Physiological causes.  Age – CI children > adult.  Sex – females > Males  Diurnal variations- low in early morning.  Environmental temperature – direct relation.  Anxiety excitement, Eating, Exercise, Pregnancy, High altitude – direct relation.  Posture change – sitting or standing > lying down due to venous pooling. Thursday, February 4, 2016
  • 29. VARIATIONS IN CARDIAC OUTPUT.  Pathological – its mainly due to low peripheral resistance  Increase  Fever  Anemia.  Hyperthyroidism.  Beriberi  Arteriovenous fistula Thursday, February 4, 2016
  • 30. VARIATIONS IN CARDIAC OUTPUT.  Decrease  CCF  Rapid arrhythmias  Cardiac shock  Incomplete heart block  Hemorrhage  Hypothyroidism. Thursday, February 4, 2016