The medical & biomedical engineering textbook:

B. Bo Sramek, Ph.D.


4th Edition

133 pages, 69 illustrations and tables

Printed in US by

ISBN 1-59196-046-0

Click here to view the first 9 pages of the textbook




Definition of hemodynamics; Systemic hemodynamics

Cardiac Output - Oxygen Transport Dynamic Modulator: Why, When and How it should be Measured

Oxygen transport and Cardiac Output (CO); Normal CO in mammals; Augmentation of CO & SV as a function of workload;, Oxygen Delivery and CO vs. survival in surgical patients; Measurement of CO: Thermodilution technique (TD); Thoracic Electrical Bioimpedance (TEB); Comparison TD vs. TEB

Oxygen Transport: Oxygen Delivery and Oxygen Consumption

Oxygen delivery; Oxygen consumption; Augmentation of oxygen delivery as a function of workload or clinical state

Hemodynamic Modulation: Per-minute or per-beat?

"Per-minute" hemodynamics: Cardiac Output - the "per-minute" blood flow parameter; "Per-minute" concepts of Preload, Contractility and Afterload - Systemic Vascular Resistance & Systemic Vascular Resistance Index (SVR/SVRI); Chronotropy; Left Cardiac Work Index - LCWI.
Hemodynamic modulation under "per-minute" hemodynamics.
Hemodynamic management under "per-minute" hemodynamics.
Fallacy of "per-minute" hemodynamics.

"Per-beat" hemodynamics - Definition and its physiologic justification.
Blood flow in "per-beat" hemodynamics (Stroke Index - SI); Blood pressure in "per-beat" hemodynamics (Mean Arterial Pressure - MAP); Vascular resistance in "per-beat" hemodynamics (Stroke Systemic Vascular Resistance Index - SSVRI). Myocardial oxygen consumption - Left Stroke Work Index (LSWI).
Hemodynamic modulation under "per-beat" hemodynamics: Preload - Intravascular volume modulation; Myocardial contractility - Mechanical (Frank-Starling) and pharmacological (inotropy) modulation; Afterlaod - Vasoactivity modulation; Perfusion blood flow- Chronotropy modulation.
Timing considerations of hemodynamic modulation.
Hemodynamic management under "per-beat" hemodynamics.

Hemodynamic Management

Graphical presentation of hemodynamic state - The Hemodynamic map.
Hemodynamic effects of vasoactivity; Effects of Central Venous Pressure (CVP) on SSVRI calculation; Hemodynamic effects of intravascular volume and inotropy.
The Hemodynamic Management Chart.
Hemodynamic responses to hemodynamic and perfusion blood flow management.
Calculations of percentage deviations in Intravascular volume, inotropy, vasoactivity and chronotropy from their respective ideal states

Hemodynamic Vectorial Effects of Different Hemodynamic Management Therapies

Hemodynamic effects of volume expansion, volume reduction (diuresis), positive and negative inotropic therapies, vasoconstriction and vasodilatation.

Normal hemodynamic, oxygen delivery and TEB values in neonatal and pediatric patients

Plots of values of 13 parameters as a function of age between birth and 15 years

Normal hemodynamic, oxygen delivery and TEB values in gravidas and nongravidas

Plots of values of 9 parameters as a function of gestation time

Hemodynamic management with "per-beat" hemodynamics: Case studies

Hemodynamic management of the surgical patient (mitral valve replacement) in the ICU.
Hemodynamic management of a hypertensive patient.


List of 24 pertinent references


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