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Related Concept Videos

Cardiac Output and Stroke Volume01:11

Cardiac Output and Stroke Volume

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Cardiac output (CO) is an integral aspect of human physiology, reflecting the heart's efficiency and responsiveness to the body's needs. It represents the volume of blood that the left or right ventricle ejects into the aorta or pulmonary trunk each minute. The CO is calculated by multiplying the heart rate (HR)—the number of heartbeats per minute—by the stroke volume (SV)—the amount of blood pumped out with each heartbeat.
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Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
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Cardiac Output I:Effect of Heart Rate on Cardiac Output01:19

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Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
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Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
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Regular physical activity is essential for maintaining cardiovascular health, with aerobic exercises being particularly effective. According to the American Heart Association, 150 minutes of moderate to intense aerobic exercise per week is recommended for a healthy heart. Aerobic activities may include brisk walking, running, bicycling, cross-country skiing, and swimming, ideally performed three to five times per week.
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Pulse01:05

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The pulse is one of the most fundamental physiological indicators of the body's cardiovascular health. It is the rhythmic expansion and contraction of the arterial walls in response to the pressure generated by the heart's pumping action.
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Pulse rate, often measured in beats per minute (bpm), reflects the heart rate (HR), which is influenced by numerous factors such as stress, physical activity, and hormonal changes. A normal resting adult pulse rate falls...
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Regulation of Stroke Volume01:27

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The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
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Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics
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The increase in cardiac output induced by a decrease in positive end-expiratory pressure reliably detects volume

Christopher Lai1, Rui Shi2, Alexandra Beurton3,4

  • 1AP-HP, Service de médecine intensive-réanimation, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS, Université Paris-Saclay, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France. christopher.lai@aphp.fr.

Critical Care (London, England)
|April 8, 2023
PubMed
Summary
This summary is machine-generated.

A transient decrease in positive end-expiratory pressure (PEEP) reliably identifies fluid responsiveness in mechanically ventilated patients. This PEEP-test accurately predicts volume responsiveness, aiding clinical decisions.

Keywords:
ARDSFluid responsivenessHemodynamic monitoringPassive leg raisingShock

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Area of Science:

  • Critical care medicine
  • Cardiopulmonary physiology
  • Mechanical ventilation

Background:

  • Positive end-expiratory pressure (PEEP) can reduce cardiac output in mechanically ventilated patients.
  • Fluid administration or passive leg raising (PLR) can improve cardiac output by increasing preload or reopening lung microvessels.
  • A PEEP-test was hypothesized as a method to assess fluid responsiveness.

Purpose of the Study:

  • To evaluate the efficacy of a transient decrease in PEEP (PEEP-test) in detecting fluid responsiveness.
  • To compare the PEEP-test with passive leg raising (PLR) for assessing volume responsiveness.

Main Methods:

  • Mechanically ventilated patients with PEEP ≥ 10 cmH2O were included.
  • Volume responsiveness was defined as a ≥ 10% increase in cardiac index (CI) during PLR.
  • The PEEP-test involved reducing PEEP to 5 cmH2O for one minute while monitoring CI.

Main Results:

  • 31 out of 64 patients were volume responsive.
  • The PEEP-test induced a significant CI increase (16%) in volume-responsive patients, but only a 6% increase in unresponsive patients.
  • A PEEP-test CI increase > 8.6% predicted volume responsiveness with 96.8% sensitivity and 84.9% specificity (AUC 0.94).

Conclusions:

  • A PEEP-test, reducing PEEP to 5 cmH2O, reliably detects volume responsiveness in mechanically ventilated patients with high PEEP.
  • The PEEP-test is a valuable tool for guiding fluid management in critical care settings.