Count to 10 - Anaesthetic Primary Podcast EP26 – Applied Cardiac Physiology Part 1 | Anaesthetic Primary Topic | Cardiac Physiology | CT10
Sep 24, 2024
Dive into the fascinating world of applied cardiac physiology! Discover how pneumoperitoneum affects the cardiovascular system, especially during laparoscopic surgeries. Learn about the body's responses to changes in patient position, exercise, and the Valsalva maneuver. Explore the impact of aging and obesity on heart function, and gain insights into the complexities of shock. This engaging discussion promises to deepen your understanding of cardiovascular dynamics in anesthetic management.
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Cardiac Effects Of Pneumoperitoneum
- Pneumoperitoneum raises intra-abdominal pressure causing initial autotransfusion then IVC compression that can reduce venous return.
- Sympathetic activation often compensates so cardiac output usually stays stable at 5–15 mmHg but fails at very high pressures or in hypovolaemia.
Manage Vagal And CO2 Effects
- Watch for vagal bradycardia during initial peritoneal stretch and be cautious in patients prone to bradycardia.
- Control CO2 absorption to avoid hypercarbia-driven sympathetic surges and acidosis.
Hydrostatic Shifts With Position
- Body hydrostatic column shifts arterial and venous pressures with position; 2.5 cm vertical change ≈2 mmHg pressure change.
- Trendelenburg transiently increases CO by ~10% then returns to baseline by 10 minutes; reverse does the opposite.