Nancy
Well-known member
This is from another site that I frequent. I thought it might be helpful in understanding Cardiac Output and Ejection Fraction Numbers.
This is the link:
http://mededcon.com/cardt_c.htm
This is the exploded information:
Cardiac Output
Ever wonder what those numbers really mean???
1. PAP SYSTOLIC
PAP SYSTOLIC (Pulmonary Artery Pressure Systolic) represents the rapid blood flow from the right ventricle into the pulmonary artery. Occurs with the opening of the pulmonic valve.
Normal: 15-30mmHg
Increase in PAS
Hypoxemia
ARDS
Pulmonary Hypertension
Left Ventricular Dysfunction which causes pulmonary overload Decrease in PAS
Hypovolemia
2. PAP DIASTOLIC
PAP DIASTOLIC (Pulmonary Artery Pressure Diastolic) represents the diminished blood flow from the right ventricle into the pulmonary artery. Occurs with the closure of the pulmonic valve.
Normal: 5-15mmHg Increase in PAD
Pulmonary Emboli
Tachycardia
Pulmonary Hypertension
Pulmonary Parenchymal Disease Decrease on PAD
Hypovolemia
3. MPAP
MPAP (Mean Pulmonary Artery Pressure) is calculated as follows:
(DPAP x 2) + SPAP
3
Normal: 7-16mmHg
Increase in PAM
ARDS
Pulmonary Hypertension
Tachycardia Decrease in PAM
Hypovolemia
4. PCWP
PCWP (Pulmonary Capillary Wedge Pressure) is an indirect indicator of left ventricular filling pressure or preload. When the balloon of the PA catheter is inflated, a branch of the pulmonary artery is occluded. The pressure that is transmitted by the pulmonary vein is approximately the same as the lead atrial pressure because there are no valves is the lung vasculature that would create a change in pressure between the left ventricle and the pulmonary vein.
Normal: 8-12mmHg Increase in PCWP
Intravascular Volume Overload
Mitral Valve Stenosis
Left Ventricular Failure
Cardiogenic Shock
High PEEP (to estimate PCWP when pt. is on PEEP: PCWP - 1/2PEEP = corrected PCWP) Decrease in PCWP
Hypovolemia
Right Ventricular Infarction
Cardiac Output
Ever wonder what those numbers really mean???
Page 2
5. CVP
CVP (Central Venous Pressure) measures right ventricular end diastolic pressure or right ventricular preload.
Normal: 2-6mmHg Increase CVP
High Intravascular Volume
Renal Failure
Pulmonary Hypertension
Vasoconstriction/Vasopressors
Hypothermia
High PEEP due to increase in intrathoracic pressure Decrease CVP
Hypovolemia
Pooling of blood in extremity or gut
Hyperthermia
3rd Spacing
Septic Shock
Arrhythmias
6. C.O.
C.O. (Cardiac Output) is the volume of blood that is ejected from the heart with each contraction per minute.
Normal: 4-8L/min
7. C.I.
C.I. (Cardiac Index) takes into account body size and cardiac output. It is a more precise measurement.
Normal: 2.5-4l/min/m2 Increase in C.I.
Hypoxia
Use of + Inotropes
Early Septic Shock
Renal Failure
Anemia Decrease in C.I.
Hypovolemia
Cardiogenic Shock
Late Septic Shock
Hypoperfusion
Arrhythmias
Metabolic Acidosis (severe)
8. SV
SV (Stroke Volume) is the quantity of blood ejected from the ventricle with each contraction. Stroke volume looks at ventricular performance or ejection without heart rate influence.
Normal: 60-100ml/beat
9. SVI
SVI (Stroke Volume Index) is the quantity of blood ejected from the heart, indexed to take into account body size. It is a more precise measurement.
Normal: 33-47ml/beat/m2 Increase in SVI
Bradycardia
Use of + Inotropes
Decrease in Afterload Decrease in SVI
Decrease in contractility
Acidosis
CHF
Hypoxemia
Hypercapnia
Increase in Afterload
Extreme Vasodilation
Tachycardia
Arrhythmias
Cardiac Output
Ever wonder what those numbers really mean???
Page 3
10. SVR
SVR (Systemic Vascular Resistance) measures the afterload or resistance applied to the left ventricle. It is an indicator of the left ventricular afterload. It is the force impeding the ejection of blood from the left ventricle.
Normal: 800-1200dynes/sec/cm2 Increase in SVR
Hypoperfusion
Hypovolemia
Hypothermia
Use of Vasopressors/Inotropes
Cardiogenic Shock
Left Ventricular Failure Decrease SVR
Sepsis
Anaphylaxis Reaction
Hyperthermia
Vasodilators
11. PVR
PVR (Pulmonary Vascular Resistance) measures the resistance or impedance of blood flow from the right ventricle against the pulmonary circulation. It measures resistance across the entire lung field.
Normal: 150-250dynes/sec/cm5 Increase PVR
CHF
Pulmonary Hypertension
Pulmonary Edema
ARDS
Hypoxia
Pulmonary Emboli
12. RVSWI
RVSWI (Right Ventricular Stroke Work Index) measures the amount of work that the right ventricle does during each contraction. It is a means of evaluating the pumping function of the right ventricle.
Normal: 10-15gm/M/M2/beat Increase in RYSWI
Pulmonary Hypertension
Increased 02 Consumption Decregse RVSWI
Heart Failure
Acidosis
13. LVSWI
LVSWI (Left Ventricular Stroke Work Index) measures the amount of work the left ventricle does during each contraction. It is a means of evaluating the pumping function of the left ventricle. It is the best measurement of contractility.
Normal: 45-75gm/M/M2/beat Increase in LVSWI
Increased 02 Consumption
Inotropes Decrease in LVSWI
MI
Heart Failure
Cardiac Output
Ever wonder what those numbers really mean???
Page 4
14. CaO2
CaO2 (Arterial Oxygen Content) is the actual amount of oxygen found bound to hemoglobin and dissolved in the plasma in each l00cc of arterial blood.
Normal: 17-20ml/dl Decrease in Ca02
Decreased Hgb levels
ARDS
Pulmonary Emboli
Pneumonia
Pulmonary Edema
Hypoxia (low pO2)
15. avDO2
avDO2 (Arteriovenous Oxygen Content Difference) is the difference between the arterial oxygen content and the mixed venous oxygen content (CaO2 - CvO2). As tissue extraction increases and mixed venous oxygen content decreases, avDO2 increases.
Normal: 4.2-5.0ml/dl
16. DO2I
DO2I (Oxygen Delivery Index) or O2AVI (Oxygen Availability Index) measures the oxygen delivery indexed to BSA.
Normal: 550-650ml/min/m2 Increase in DO2I
Sepsis Syndrome
Hyperthermia
Inotropes Decrease in DO2I
Hypoxia
Hypothermia
Hypovolemia
Hypothyroidism
Low Cardiac Output
Anemia
17. VO21
VO21 (Oxygen Consumption Index) amount of oxygen consumed by the tissue per minute indexed to BSA.
Normal: 115-165ml/min/M2 Increase in VO2I
Acidosis
Seizures
Hyperthermia
Early Sepsis
Pain/Restlessness/Agitation/Shivering Decrease in VO2I
Oxyhemoglobin Curve Shift to the Left
(Hypocapnia, Alkalosis, Hypothermia)
General Anesthesia
Late Sepsis
Decreased Metabolic Rate
18. O2ER
O2ER (Oxygen Extraclion Ratio) reflects the use of oxygen by the tissues. It is the fraction of available oxygen that is consumed by the tissues.
Normal: 24-28% Increase in O2ERShock
Hypovolemia
Hypoperfusion
Early Sepsis
Hyperthermia
Pain/Fear/Anxiety
Anemia
Hypoxia Decrease in O2ER
Physiological Shunt
Decreased Metabolic Rate
Alkalosis
Anesthesia
Hypothermia
Sepsis
Cardiac Output
Ever wonder what those numbers really mean???
Page 5
19. AaDO2 or A-a Gradient
AaDO2 or A-a Gradient (Alveoli-Arterial Oxygen Difference) measures the difference in partial pressure of oxygen between the alveoli and the arteries. This measures the efficiency of the oxygen exchange between the lung alveoli and the pulmonary capillaries.
Normal: 10-15mmHg Increase in AaDO2
Respiratory Failure
ARDS
Shunting
Pulmonary Edema
COPD
Pneumonia
20. QS/QT
QS/QT (% of Arterio-venous Shunt) is the extent to which arterial blood is less than maximally oxygenated. It is the blood returning to the left heart without being oxygenated. It measures the amount of shunting.
Normal: 3-5 Increase in QS/QT
ARDS
Severe Pulmonary Dysfunction
Pneumonia
Atelectasis
Pulmonary Emboli
Pulmonary Edema
COPD NOTE: Increasing FI02 alone will not improve the shunt.
21. EJ
EJ (Ejection Fraction) is stroke volume expressed as a percentage of end diastolic volume.
Normal: 65%
22. SvO2
SvO2 (Mixed Venous Oxygen Saturation) represents the end result of both oxygen delivery and consumption at the tissue level. Can be the earliest indicator of acute deterioration. It is determined by four interacting variables: SaO2, Cardiac Output, Hemoglobin, and O2 Consumption. It is drawn from the PA port of the Swan Ganz because it is blood that has been blended in the Right Ventricle. It is a mixture of blood from the Inferior Vena Cava, Superior Vena Cave, and the Coronary Circulation.
Increase in SvO2
Hypothermia
Anesthesia
Pharmacologic Paralysis
Sepsis
Alkalosis
Carbon Monoxide Poisoning
Liver Disease (Cirrhosis)
Wedging Decrease In SvO2
Hyperthermia
Anemia
Hemorrhage
Late Sepsis
Acidosis
Hypoxia
Shock
Hypovolemia
Arrhythmias
Pain
Shivering
Seizures
Restlessness/Agitation
This is the link:
http://mededcon.com/cardt_c.htm
This is the exploded information:
Cardiac Output
Ever wonder what those numbers really mean???
1. PAP SYSTOLIC
PAP SYSTOLIC (Pulmonary Artery Pressure Systolic) represents the rapid blood flow from the right ventricle into the pulmonary artery. Occurs with the opening of the pulmonic valve.
Normal: 15-30mmHg
Increase in PAS
Hypoxemia
ARDS
Pulmonary Hypertension
Left Ventricular Dysfunction which causes pulmonary overload Decrease in PAS
Hypovolemia
2. PAP DIASTOLIC
PAP DIASTOLIC (Pulmonary Artery Pressure Diastolic) represents the diminished blood flow from the right ventricle into the pulmonary artery. Occurs with the closure of the pulmonic valve.
Normal: 5-15mmHg Increase in PAD
Pulmonary Emboli
Tachycardia
Pulmonary Hypertension
Pulmonary Parenchymal Disease Decrease on PAD
Hypovolemia
3. MPAP
MPAP (Mean Pulmonary Artery Pressure) is calculated as follows:
(DPAP x 2) + SPAP
3
Normal: 7-16mmHg
Increase in PAM
ARDS
Pulmonary Hypertension
Tachycardia Decrease in PAM
Hypovolemia
4. PCWP
PCWP (Pulmonary Capillary Wedge Pressure) is an indirect indicator of left ventricular filling pressure or preload. When the balloon of the PA catheter is inflated, a branch of the pulmonary artery is occluded. The pressure that is transmitted by the pulmonary vein is approximately the same as the lead atrial pressure because there are no valves is the lung vasculature that would create a change in pressure between the left ventricle and the pulmonary vein.
Normal: 8-12mmHg Increase in PCWP
Intravascular Volume Overload
Mitral Valve Stenosis
Left Ventricular Failure
Cardiogenic Shock
High PEEP (to estimate PCWP when pt. is on PEEP: PCWP - 1/2PEEP = corrected PCWP) Decrease in PCWP
Hypovolemia
Right Ventricular Infarction
Cardiac Output
Ever wonder what those numbers really mean???
Page 2
5. CVP
CVP (Central Venous Pressure) measures right ventricular end diastolic pressure or right ventricular preload.
Normal: 2-6mmHg Increase CVP
High Intravascular Volume
Renal Failure
Pulmonary Hypertension
Vasoconstriction/Vasopressors
Hypothermia
High PEEP due to increase in intrathoracic pressure Decrease CVP
Hypovolemia
Pooling of blood in extremity or gut
Hyperthermia
3rd Spacing
Septic Shock
Arrhythmias
6. C.O.
C.O. (Cardiac Output) is the volume of blood that is ejected from the heart with each contraction per minute.
Normal: 4-8L/min
7. C.I.
C.I. (Cardiac Index) takes into account body size and cardiac output. It is a more precise measurement.
Normal: 2.5-4l/min/m2 Increase in C.I.
Hypoxia
Use of + Inotropes
Early Septic Shock
Renal Failure
Anemia Decrease in C.I.
Hypovolemia
Cardiogenic Shock
Late Septic Shock
Hypoperfusion
Arrhythmias
Metabolic Acidosis (severe)
8. SV
SV (Stroke Volume) is the quantity of blood ejected from the ventricle with each contraction. Stroke volume looks at ventricular performance or ejection without heart rate influence.
Normal: 60-100ml/beat
9. SVI
SVI (Stroke Volume Index) is the quantity of blood ejected from the heart, indexed to take into account body size. It is a more precise measurement.
Normal: 33-47ml/beat/m2 Increase in SVI
Bradycardia
Use of + Inotropes
Decrease in Afterload Decrease in SVI
Decrease in contractility
Acidosis
CHF
Hypoxemia
Hypercapnia
Increase in Afterload
Extreme Vasodilation
Tachycardia
Arrhythmias
Cardiac Output
Ever wonder what those numbers really mean???
Page 3
10. SVR
SVR (Systemic Vascular Resistance) measures the afterload or resistance applied to the left ventricle. It is an indicator of the left ventricular afterload. It is the force impeding the ejection of blood from the left ventricle.
Normal: 800-1200dynes/sec/cm2 Increase in SVR
Hypoperfusion
Hypovolemia
Hypothermia
Use of Vasopressors/Inotropes
Cardiogenic Shock
Left Ventricular Failure Decrease SVR
Sepsis
Anaphylaxis Reaction
Hyperthermia
Vasodilators
11. PVR
PVR (Pulmonary Vascular Resistance) measures the resistance or impedance of blood flow from the right ventricle against the pulmonary circulation. It measures resistance across the entire lung field.
Normal: 150-250dynes/sec/cm5 Increase PVR
CHF
Pulmonary Hypertension
Pulmonary Edema
ARDS
Hypoxia
Pulmonary Emboli
12. RVSWI
RVSWI (Right Ventricular Stroke Work Index) measures the amount of work that the right ventricle does during each contraction. It is a means of evaluating the pumping function of the right ventricle.
Normal: 10-15gm/M/M2/beat Increase in RYSWI
Pulmonary Hypertension
Increased 02 Consumption Decregse RVSWI
Heart Failure
Acidosis
13. LVSWI
LVSWI (Left Ventricular Stroke Work Index) measures the amount of work the left ventricle does during each contraction. It is a means of evaluating the pumping function of the left ventricle. It is the best measurement of contractility.
Normal: 45-75gm/M/M2/beat Increase in LVSWI
Increased 02 Consumption
Inotropes Decrease in LVSWI
MI
Heart Failure
Cardiac Output
Ever wonder what those numbers really mean???
Page 4
14. CaO2
CaO2 (Arterial Oxygen Content) is the actual amount of oxygen found bound to hemoglobin and dissolved in the plasma in each l00cc of arterial blood.
Normal: 17-20ml/dl Decrease in Ca02
Decreased Hgb levels
ARDS
Pulmonary Emboli
Pneumonia
Pulmonary Edema
Hypoxia (low pO2)
15. avDO2
avDO2 (Arteriovenous Oxygen Content Difference) is the difference between the arterial oxygen content and the mixed venous oxygen content (CaO2 - CvO2). As tissue extraction increases and mixed venous oxygen content decreases, avDO2 increases.
Normal: 4.2-5.0ml/dl
16. DO2I
DO2I (Oxygen Delivery Index) or O2AVI (Oxygen Availability Index) measures the oxygen delivery indexed to BSA.
Normal: 550-650ml/min/m2 Increase in DO2I
Sepsis Syndrome
Hyperthermia
Inotropes Decrease in DO2I
Hypoxia
Hypothermia
Hypovolemia
Hypothyroidism
Low Cardiac Output
Anemia
17. VO21
VO21 (Oxygen Consumption Index) amount of oxygen consumed by the tissue per minute indexed to BSA.
Normal: 115-165ml/min/M2 Increase in VO2I
Acidosis
Seizures
Hyperthermia
Early Sepsis
Pain/Restlessness/Agitation/Shivering Decrease in VO2I
Oxyhemoglobin Curve Shift to the Left
(Hypocapnia, Alkalosis, Hypothermia)
General Anesthesia
Late Sepsis
Decreased Metabolic Rate
18. O2ER
O2ER (Oxygen Extraclion Ratio) reflects the use of oxygen by the tissues. It is the fraction of available oxygen that is consumed by the tissues.
Normal: 24-28% Increase in O2ERShock
Hypovolemia
Hypoperfusion
Early Sepsis
Hyperthermia
Pain/Fear/Anxiety
Anemia
Hypoxia Decrease in O2ER
Physiological Shunt
Decreased Metabolic Rate
Alkalosis
Anesthesia
Hypothermia
Sepsis
Cardiac Output
Ever wonder what those numbers really mean???
Page 5
19. AaDO2 or A-a Gradient
AaDO2 or A-a Gradient (Alveoli-Arterial Oxygen Difference) measures the difference in partial pressure of oxygen between the alveoli and the arteries. This measures the efficiency of the oxygen exchange between the lung alveoli and the pulmonary capillaries.
Normal: 10-15mmHg Increase in AaDO2
Respiratory Failure
ARDS
Shunting
Pulmonary Edema
COPD
Pneumonia
20. QS/QT
QS/QT (% of Arterio-venous Shunt) is the extent to which arterial blood is less than maximally oxygenated. It is the blood returning to the left heart without being oxygenated. It measures the amount of shunting.
Normal: 3-5 Increase in QS/QT
ARDS
Severe Pulmonary Dysfunction
Pneumonia
Atelectasis
Pulmonary Emboli
Pulmonary Edema
COPD NOTE: Increasing FI02 alone will not improve the shunt.
21. EJ
EJ (Ejection Fraction) is stroke volume expressed as a percentage of end diastolic volume.
Normal: 65%
22. SvO2
SvO2 (Mixed Venous Oxygen Saturation) represents the end result of both oxygen delivery and consumption at the tissue level. Can be the earliest indicator of acute deterioration. It is determined by four interacting variables: SaO2, Cardiac Output, Hemoglobin, and O2 Consumption. It is drawn from the PA port of the Swan Ganz because it is blood that has been blended in the Right Ventricle. It is a mixture of blood from the Inferior Vena Cava, Superior Vena Cave, and the Coronary Circulation.
Increase in SvO2
Hypothermia
Anesthesia
Pharmacologic Paralysis
Sepsis
Alkalosis
Carbon Monoxide Poisoning
Liver Disease (Cirrhosis)
Wedging Decrease In SvO2
Hyperthermia
Anemia
Hemorrhage
Late Sepsis
Acidosis
Hypoxia
Shock
Hypovolemia
Arrhythmias
Pain
Shivering
Seizures
Restlessness/Agitation
