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samenvatting hartdebiet
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samenvatting van hartdebiet
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SAMENVATTING HARTDEBIETHART
Functie: arterieel BD onderhouden zodat er voldoende bloed door weefsels kan stromen
Contractie spieren maakt voldoende druk
Bloedvolume dat door aortaklep gaat = slagvolume
Hartdebiet (HD) : slagvolume (SV) x hartslag (HF)
Normaal: 5-6 liter/min
Cardiale index (inschatten metabole noden) : HD/BSA
BSA= (body surface area) = wortel (lengte x gewicht /3600)
MEETTECHNIEKEN
Flowmeters (elektromagnetisch of doppler)
Thermosdilutie-techniek (injectie koude vloeistof & meting temp a. pulmonalis)
Echocardiografie
Nuclaire technieken (aantal fotonen tellen bij systole & diastole voor ejectiefractie bepalen)
Fick methode: telling hemoglobine & bepaling HD
VERBAND HARTDEBIET & HARTSLAG
Hartfrequentie veranderingen hebben meer invloed dan SV om HD te verhogen
SLAGVOLUME
+ Positieve invloed door toename EDV (eind diastolische volume)
Door meer preload
-negatieve invloed door toename ESV (eind systolische volume)
Door meer afterload
Minder inotropie
, PRELOAD
Initiële uitrekking hartspier kan voor toename contractie mogelijkheid zorgen
Hierdoor kan de spanning toenemen
! er is een limiet om de preload -> teveel uitrekking van hartspier !
Contractie is afhankelijk van overlapping actine myosine-filamenten
! bij teveel rekking kunnen myosinekopjes zich niet meer hechten aan actine!
(Sacromeerlengte kan in intact hart niet bepaald worden )
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