Tutorial 9: Venous Return скачать в хорошем качестве

Tutorial 9: Venous Return

Welcome to the final module of part 1 of the course. We are now entering the realm of material that may be unfamiliar to you and I must warn you – the contents of the next 3 tutorials are not universally accepted. Nevertheless, this to me represents my best understanding of physiology and published literature. The first tutorial of this module involves venous return. A lot of the material will be familiar to you if you read Arthur Guyton’s physiology textbook. There are a few tweaks nonetheless. I would like to acknowledge the work of Sheldon Magder and Simon Gelman - who have framed my understanding of this topic. @ccmtutorials www.ccmtutorials.org 0:00 Beginning 01:10 Contents 01:30 Clinical Scenario (postoperative patient, blood loss, epidural, vasopressor infusion) 04:30 Cardiac Output and Venous Return 06:30 The Mean Systemic Pressure and Venous Return 08:10 Stadium Analogy 10:00 The Bathtub Analogy 12:00 Compliance of the Vascular System and Tire Analogy 14:00 Unstressed versus Stressed Blood Volume 18:30 Venous Return, Mean Systemic Pressure and Vascular Compliance 19:00 What Happens to the Stressed Blood Volume During Anesthesia & Surgery 20:00 Clinical Scenario Revisited 21:00 Treating Loss of Stressed Blood Volume (fluid vs vaspopressors) 22:50 Fast versus Slow Vascular Compartments 24:40 Low Dose Vasopressors and Venous Return 26:10 High Dose Vasopressors, Venous Return and Cardiac Output 27:20 Bathtub Analogy Revisited 29:30 Hypervolemia (full stressed blood volume) 32:30 Fluid Overload on the Venous Side of the Circulation 34:00 Why "loading the CVP is bad" 34:40 Treating Hypervolemia 35:50 Review