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Hemodynamics Physics of Blood flow in the circulation
Circulatory System ,[object Object],[object Object],[object Object]
 
Left Side of Heart    Lungs Tissues Circulation Schematic Right Side of Heart A V V A Pulmonary Vein Pulmonary Artery Aorta Sup. & Inf. Vena Cava Pulmonary Valve Aortic Valve Tricuspid Valve Mitral Valve
Blood Vessels ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Blood ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Hemodynamic Principles ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Output ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Four determinants of cardiac output Heart Rate  x  Stroke Volume Contractility Afterload Preload
 
Starling’s Law ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Preload Preload is the stretch of the balloon as air is blown into it. The more air, the greater the stretch.
Preload and Cardiac Output ,[object Object],[object Object],[object Object],[object Object]
Preload ,[object Object],[object Object],[object Object],[object Object],[object Object]
Increasing Preload: ,[object Object],[object Object],[object Object],[object Object]
Low CVP ,[object Object],[object Object],[object Object]
Elevated CVP ,[object Object],[object Object],[object Object],[object Object],[object Object]
Left Heart Preload ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Afterload Resistance is the knot on the end of the balloon, which the balloon has to work against to get the air out.
Factors Affecting Afterload ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Afterload Reduction: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Afterload Increase and Increasing the BP: ,[object Object],[object Object],[object Object],[object Object],[object Object]
IABP ,[object Object],[object Object]
 
[object Object],[object Object],[object Object],Contractility The more air in the balloon, the greater the stretch, the farther the balloon will fly when air is released.
[object Object],[object Object],Contractility
Increased Contractility ,[object Object],[object Object],[object Object],[object Object]
Decreased contractility ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Improving Contractility: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hemodynamic Monitoring ,[object Object]
Examples of hemodynamic monitoring devices: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Arterial Line Monitoring ,[object Object]
[object Object],[object Object],[object Object],[object Object],Arterial Line waveform
Leveling and Zeroing System
Central Venous Pressure/ RA Pressure Monitoring ,[object Object],[object Object],[object Object]
RA/CVP Catheter Placement
RA/CVP Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Use brown port for CVP monitoring. Arrow triple lumen CVC
PA Pressure & Waveform Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pulmonary Artery Catheter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PA Catheter Inflated for Wedge Pressure
PA Waveform Progression
PA Wedge Pressure  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What the hell are you talking about ?
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],2.  CONTRACTILITY - forcefulness of contractility  Ca+ channel blockers  Digoxin  Dopamine/Dobutamine  Milrinone/amrinone 3. AFTERLOAD  – work required to open aortic valve and eject blood – resistance to flow in arteries °   Dopamine (at higher doses)    Ace inhibitors    Nipride/lesser extent Nitro    Calcium channel  blockers    Labetalol Drugs of Hemodynamics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Q & A...... Whew....Glad thats over  !!!!
 

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Hemodynamics.kiran rai

Notas del editor

  1. Afterload is the pressure the ventricles must OVERCOME in order to pump the blood past the aorta.
  2. Anacrotic rise is the initital upward slope of the waveform when the ventricle is contracting and forcing open the aortic valve.