Hemodynamics.kiran rai

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]

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

Central Venous Pressure/ RA Pressure Monitoring ,[object Object],[object Object],[object Object]

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 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 !!!!

Hemodynamics.kiran rai

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