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31 Cards in this Set

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Normal EF

60%

Increased pulse pressure does what to cardiac output

Decreases cardiac output

3 causes of metabolic acidosis

Renal failure, lactic acidosis, DKA

2 goals of critical care

Enhance oxygen delivery, decrease oxygen demand

What increases oxygen demand?

Anything that uses O2 (movement, pain)

What happens when peep is increased in ARDs?

Decrease cardiac output

Pressure in the right ventricle is...

Low

What happens in right ventricular failure?

Ventricle dilates, blood backs up into right atrium and SVC and inferior vena cava --> tachycardia, JVD & hepatic congestion



*lungs will be clear, CVP is increased

Causes of right ventricular failure

Acute right ventricular infarction, PE, elevated pulmonary pressure

Treatment of right ventricular failure

Give volume (20-30ml/kg)

What happens in left ventricular failure?

LV dilates, blood backs up into LA and into pulmonary veins --> increased pulmonary pressure and pulmonary edema



* tachycardia, tales, tachypnea

Causes of LV failure

Acute left ventricular infarction, cardiomyopathies

LV failure treatment

Fluid restriction, diuresis

RCA perfuses

Right atrium, right ventricle, inferior left ventricle

RCA occlusion causes what rhythms?

Bradycardia, 1st degree HB

LCA perfuses

Left main

Left circ. Perfuses

Left atrium, lateral left ventricle wall

LAD perfuses

Anterior and apex of LV, 2/3 ventricular septum

LAD occlusion causes what rhythms?

VT, Vfib

During what part of the cardiac cycle do coronaries fill?

Diastole

What is stroke volume

Amount of blood ejected with each ventricular contraction

What is preload?

Amount of volume returned to the ventricle at the end of diastole

SV=

Preload, afterload, contractility

How to treat when preload is overloaded

NTG (low dose) vasodilates, diuretic

What is afterload

Workload of the ventricle to pump the blood out

How to treat when preload is low

Give volume

If SV is up CO is

Down

Drugs to reduce afterload

ACE, ARB (Angio-receptor blockers : Diovan), alpha antagonists : hydralazine (needed q6/q8); clonidine (allows vascular relaxation), BB, CaCh blockers : Norvasc

Vascular smooth muscle relaxers, decrease the workload of the left ventricle

Drugs to increase afterload

Levo, Vaso, Neo, Dopa (10-20 mcg/kg for vasoconstriction)

Increase arterial tone, vasoconstrictors

Contractility

Ability of the ventricular muscle to contract and eject blood

Drugs that improve contractility

Dig, Dobutamine, Milrinone, Dopa (5mcg/kg)