This document discusses the basic cardiac physiology used to manage critically ill patients, including determinants of mean arterial pressure, cardiac output, and oxygen delivery. It describes how these concepts are used to diagnose different types of shock. Monitoring of central venous pressure is discussed as well as equations relating mean arterial pressure, stroke volume, heart rate, and systemic vascular resistance. The importance of oxygen delivery to tissues and maintaining an optimal venous oxygen saturation is emphasized.

1. Hemodynamics Dalhousie Critical Care Lecture Series

4. Determinants of SV

5. The Need for Preload

6. Preload Estimates with error JVP CVP RAP RVEDP PAD PAWP LVEDP LVEDV

7. Right Atrial Waveform

8. Looking Carefully at the JVP/CVP

9. The Role of Afterload

12. What happens when VO 2 > DO 2 ?

15. All of Cardiac Physiology in a Nut Shell

21. Using the Swan-Ganz catheter to diagnose type of shock

22. Using the Swan-Ganz catheter to diagnose type of shock O 2 extraction + SVR Septic shock O 2 extraction + SVR Cardiogenic shock O 2 extraction + SVR Hypovolemic shock RVEDV PAP /N PAWP V V Right ventricular failure PAD/PAWP equalised Cardiac tamponade giant ‘v’ waves on PAWP trace Acute mitral regurgitation O 2 step up noted in SvO 2 giant ‘v’ waves on PAWP trace Acute venticular septal defect Pulm Vasc Res PAD>PAWP by >5 mmHg Massive pulmonary embolism PAWP > 25mmHg N/ Cardiogenic pulmonary edema Left ventricular failure Notes PAP/PAWP CVP/RAP CO/CI MAP HR Condition