Cardiac output measurement.pptx
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Cardiac output is the product of heart rate and stroke volume measured in liters per minute. Measurement of cardiac output is important for managing hemodynamically unstable patients by assessing cardiac preload and response to interventions. Methods for measuring cardiac output include thermodilution, Doppler ultrasound, echocardiography, Fick principle, impedance cardiography, and arterial pressure waveform analysis. Thermodilution involves injecting cold fluid and measuring downstream temperature change, while Doppler ultrasound and echocardiography use sound waves to evaluate blood flow noninvasively.
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Cardiac output monitoring provides important information about a patient's hemodynamic status. There are several invasive and non-invasive methods to measure cardiac output. Invasive methods include thermodilution, Fick method, lithium dilution. Thermodilution, using a pulmonary artery catheter, is considered the clinical gold standard but has fallen out of favor due to risks. Non-invasive options include esophageal Doppler, bioreactance, pulse contour analysis, and partial CO2 rebreathing. Choice of monitoring method depends on the patient's condition and goals of therapy.
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Cardiac output monitoring provides essential information about heart function and tissue perfusion. There are various methods of monitoring cardiac output, ranging from non-invasive to invasive. The pulmonary artery catheter, which involves thermodilution, has long been the gold standard but is invasive. Less invasive methods like lithium dilution and pulse contour analysis are also used. The ideal method would be non-invasive, accurate, continuous and reproducible across patients, but no single technique currently meets all these criteria.
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Cardiac output monitoring can be done using invasive, minimally invasive, and non-invasive methods. Invasive methods like pulmonary artery catheter use thermodilution or dye dilution to directly measure cardiac output but carry risks. Minimally invasive methods like LiDCO, PiCCO, and FloTrac use pulse contour analysis after initial calibration. Non-invasive options include thoracic bioimpedance and echocardiography. The choice of monitoring method depends on factors like accuracy, ease of use, risks, and costs. While goal-directed therapy using cardiac output monitoring may improve outcomes in some high-risk patients, large trials found no clear benefit of pulmonary artery catheters on mortality.
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This document outlines various methods for measuring cardiac output. It begins with a historical perspective on cardiac output measurement, noting that Adolf Fick first developed a technique for measuring it in 1870 using what is now called the Fick principle. The document then discusses the importance of cardiac output and ideal features of measurement devices. It describes both non-invasive techniques like echocardiography and invasive methods like thermodilution that use indicator dilution. The relationship between cardiac output, stroke volume, heart rate and cardiac reserve is also explained.
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Cardiac output monitoring can be done using invasive, minimally invasive, and non-invasive methods. Invasive methods like pulmonary artery catheter use thermodilution or dye dilution to directly measure cardiac output but carry risks. Minimally invasive methods like LiDCO, PiCCO, and FloTrac use pulse contour analysis after initial calibration. Non-invasive options include thoracic bioimpedance and echocardiography. The choice of monitoring method depends on factors like accuracy, ease of use, risks, and costs. While goal-directed therapy using cardiac output monitoring may improve outcomes in some high-risk patients, large trials found no clear benefit of pulmonary artery catheters on mortality.
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This document discusses cardiac output and various methods for measuring it. Cardiac output is defined as the volume of blood pumped by the heart per minute and is calculated as heart rate multiplied by stroke volume. Several non-invasive and minimally invasive methods for measuring cardiac output are outlined, including Doppler ultrasound, dye dilution, pulse pressure analysis, impedance cardiography, and magnetic resonance imaging. Factors that can affect cardiac output include stroke volume and heart rate. The document provides details on the techniques and procedures for several of these cardiac output measurement methods.
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2) Thermodilution, using a pulmonary artery catheter, is another common method where cardiac output is calculated based on how fast injected cold saline is mixed and diluted by flowing blood.
3) Non-invasive methods like Doppler ultrasound and impedance plethysmography can also estimate cardiac output by measuring aortic blood flow or chest impedance changes during the cardiac cycle.
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Cardiac output can be measured through various invasive and non-invasive methods. The pulmonary artery catheter using thermodilution is still considered the gold standard but is invasive. Minimally invasive methods include lithium dilution, pulse contour analysis devices, esophageal Doppler, and transesophageal echocardiography. Non-invasive options include partial gas rebreathing, thoracic bioimpedance, and Doppler ultrasound. The ideal monitor is accurate, continuous, non-invasive and provides reliable measurements during different physiological states.
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Cardiac output can be measured through both invasive and non-invasive methods. Invasive methods include thermodilution using a pulmonary artery catheter, which involves injecting cold saline and measuring temperature changes. Less invasive methods include transpulmonary thermodilution using a central venous catheter. Non-invasive methods include pulse contour analysis, bioreactance, vascular unloading techniques, pulse wave transit time, and radial artery tonometry. Continuous cardiac output monitoring provides advantages over intermittent thermodilution but validation studies show good correlation between methods.
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Cardiac output can be measured directly or indirectly using various methods. Direct methods involve placing a flow meter in the aorta, while indirect methods include the Fick method (measuring oxygen consumption), indicator dilution (injecting a dye), and thermodilution (injecting cold saline). Cardiac output is affected by factors like exercise, which increases it through sympathetic stimulation and increased venous return, and posture, as standing decreases it by pulling blood to the lower extremities. Normal cardiac output is 5-6 L/min in adults but varies based on age, gender, body size, and physiological conditions.
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Cardiac output can be measured using invasive and non-invasive methods. Invasive methods include the Fick method, dye dilution, and thermodilution, which require a pulmonary artery catheter. Non-invasive methods include echocardiography, which uses ultrasound to visualize cardiac structures and Doppler to measure blood flow velocities, and pulse pressure analysis. Measurement of cardiac output is important for critically ill patients to optimize oxygen delivery and support circulation.
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PULSE OXIMETRY
Pulse oximetry is a noninvasive test that uses light to measure the oxygen saturation level in a person's blood. A clip-like probe is placed on the finger or earlobe and uses red and infrared light wavelengths absorbed differently by oxygenated and deoxygenated hemoglobin to calculate the oxygen saturation percentage. This information helps healthcare providers determine if a patient needs supplemental oxygen or how well treatment is working. However, pulse oximetry has limitations as it does not measure other blood gas levels, ventilation, or oxygen metabolism and can be affected by factors like carbon monoxide, anemia, blood flow, and skin pigmentation.
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2) Thermodilution, using a pulmonary artery catheter, is another common method where cardiac output is calculated based on how fast injected cold saline is mixed and diluted by flowing blood.
3) Non-invasive methods like Doppler ultrasound and impedance plethysmography can also estimate cardiac output by measuring aortic blood flow or chest impedance changes during the cardiac cycle.
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Cardiac output is the volume of blood pumped each minute and is equal to stroke volume multiplied by heart rate. The document discusses factors that affect cardiac output such as hormones, fitness levels, age, heart size, contractility, and gender. It also discusses several methods for measuring cardiac output including indicator dilution and Doppler echocardiography. Finally, it provides an overview of electrocardiography and the waves that make up an ECG including the P, QRS, T, and U waves and what each represents in the cardiac cycle.
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The document summarizes various monitoring devices used during anesthesia, including essential monitors like ECG, non-invasive blood pressure, pulse oximetry, capnography, and vapor concentration analyzers. It also discusses immediately available monitors like peripheral nerve stimulators and temperature monitors. Additional monitors that may be required in some cases include invasive blood pressure, urine output, central venous pressure, pulmonary artery pressure, and cardiac output, which can be measured using a pulmonary artery catheter.
PiCCO Monitor
This document discusses PiCCO (Pulse Contour Cardiac Output) monitoring. PiCCO enables assessment of a patient's hemodynamic status by measuring various volumetric and cardiac parameters. It requires a central venous pressure catheter and arterial line. PiCCO works by transpulmonary thermodilution, using cold saline injections to calculate volumes, and pulse contour analysis of the arterial waveform to provide continuous cardiac output monitoring. The document defines various parameters measured by PiCCO like preload, contractility, lung function, and afterload, and provides normal ranges. It also outlines indications, contraindications and the decision tree for hemodynamic monitoring using PiCCO.
cardiacoutputmonitoring-190708221224.pdf
Cardiac output can be measured through various invasive and non-invasive methods. The pulmonary artery catheter using thermodilution is still considered the gold standard but is invasive. Minimally invasive methods include lithium dilution, pulse contour analysis devices, esophageal Doppler, and transesophageal echocardiography. Non-invasive options include partial gas rebreathing, thoracic bioimpedance, and Doppler ultrasound. The ideal monitor is accurate, continuous, non-invasive and provides reliable measurements during different physiological states.
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Cardiac output can be measured through various invasive and non-invasive methods. The pulmonary artery catheter using thermodilution is still considered the gold standard but is invasive. Minimally invasive methods include lithium dilution, pulse contour analysis devices, esophageal Doppler, and transesophageal echocardiography. Non-invasive methods include partial gas rebreathing, thoracic bioimpedance, and Doppler ultrasound. The ideal monitor is accurate, continuous, non-invasive and provides reliable measurements during different physiological states.
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The document discusses factors that regulate cardiac output, including preload, contractility, and afterload. It describes how the respiratory pump, cardiac pump, muscle pump, and mean circulatory filling pressure affect cardiac output by changing preload. Sympathetic stimulation and hormones are discussed as factors increasing contractility. Methods for measuring cardiac output are also summarized, including the Fick principle, indicator dilution, thermodilution, Doppler echocardiography, and impedance cardiography. Cardiac output is increased in conditions like fever and anemia that cause increased metabolism, and decreased in states of weak contractions or poor pumping like congestive heart failure.
satya sai 2018 cardiac output.pdf
Cardiac output can be measured through both invasive and non-invasive methods. Invasive methods include thermodilution using a pulmonary artery catheter, which involves injecting cold saline and measuring temperature changes. Less invasive methods include transpulmonary thermodilution using a central venous catheter. Non-invasive methods include pulse contour analysis, bioreactance, vascular unloading techniques, pulse wave transit time, and radial artery tonometry. Continuous cardiac output monitoring provides advantages over intermittent thermodilution but validation studies show good correlation between methods.
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Cardiac output can be measured directly or indirectly using various methods. Direct methods involve placing a flow meter in the aorta, while indirect methods include the Fick method (measuring oxygen consumption), indicator dilution (injecting a dye), and thermodilution (injecting cold saline). Cardiac output is affected by factors like exercise, which increases it through sympathetic stimulation and increased venous return, and posture, as standing decreases it by pulling blood to the lower extremities. Normal cardiac output is 5-6 L/min in adults but varies based on age, gender, body size, and physiological conditions.
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Cardiac output measurement.pptx
- 1. Cardiac Output Measurement Ms.P.Nishanthi KIT-CBE
- 2. Introduction to Cardiac Output ● Cardiac output is the product of heart rate (HR) and stroke volume (SV) and is measured in liters per minute. ● HR is most commonly defined as the number of times the heart beats in one minute. ● SV is the volume of blood ejected during ventricular contraction or for each stroke of the heart.
- 3. Importance of Cardiac Output Measurement ● The management of hemodynamically unstable patients requires an assessment of the cardiac output (CO) and the patients' intravascular volume status (cardiac preload). ● In most instances the absolute value of the CO is less important than the response of the CO to a therapeutic intervention.
- 4. Methods for Cardiac Output Measurement ● Thermodilution ● Doppler Ultrasound ● Echocardiography ● Fick Principle ● Impedance Cardiography ● Arterial Pressure Waveform Analysis
- 5. Thermodilution Method ● The thermodilution method involves injection of a definite amount of heat into the bloodstream, and the corresponding downstream temperature change is recorded. ● A cold fluid is often used as an indicator in the thermodilution method, because cold fluid is less harmful to the blood and tissue than a hot fluid.
- 6. Doppler Ultrasound ● A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. ● A regular ultrasound uses sound waves to produce images, but can't show blood flow.
- 7. Echocardiography ● An echocardiogram uses sound waves to create pictures of the heart. This common test can show blood flow through the heart and heart valves. ● Your health care provider can use the pictures from the test to find heart disease and other heart conditions.
- 8. Fick Principle ● The Fick principle states that uptake of oxygen in blood by the lung (mL/min) is equal to the product of the AVO2 diff of the oxygen and the blood flow to the lung. ● Therefore, if the arterial O2 content, venous O2 content and oxygen consumption are measured, the CO can then be calculated.
- 9. Impedance Cardiography ● Impedance cardiography and bioreactance are two methods of quantifying cardiac function without invasive monitoring. ● Both methods use electrophysiology to measure how changes in aortic blood volume and flow influence transmission of a known electrical current across the thorax.
- 10. Arterial Pressure Waveform Analysis ● The arterial waveform reflects the change in pressure over time, or dP/dt, and thus the slope of the upstroke reflects this. ● Generally speaking, the steeper the slope, the quicker the rise, the greater the dP/ dt, and the stronger the contractile forces appear.
- 11. Clinical Applications ● Management of heart failure ● Assessment of shock ● Intraoperative monitoring ● Intensive care settings
- 12. Factors Affecting Cardiac Output ● Management of heart failure ● Assessment of shock ● Intraoperative monitoring ● Intensive care settings