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2012•Critical CareOpen access

Frank-Starling and Guyton together at bedside during a fluid challenge

H. Aya, Maurizio Cecconi, Martin Geisen, Claudia Ebm, M Grounds, Nick Fletcher, Andrew Rhodes

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Abstract

According to Guyton, the difference between mean systemic filling pressure (Pms) and right atrial pressure (RAP) is the venous pressure gradient (VP). This is proportional to venous return and cardiac output (CO). According to the Frank-Starling law a fluid challenge successfully increases the stroke volume if the preload increases in the ascending part of the curve. The aim of this study was to assess the significance of the analogue of the Pms (Pmsa) measured with the Navigator™ (Applied Physiology, St Leonards, Australia), the central venous pressure (CVP) (as a surrogate of RAP) and the VP during a fluid challenge.

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What this paper is about

According to Guyton, the difference between mean systemic filling pressure (Pms) and right atrial pressure (RAP) is the venous pressure gradient (VP). This is proportional to venous return and cardiac output (CO). According to the Frank-Starling law a fluid challenge successfully increases the stroke volume if the preload increases in the ascending part of the curve. The aim of this study was to assess the significance of the analogue of the Pms (Pmsa) measured with the Navigator™ (Applied Physiology, St Leonards, Australia), the central venous pressure (CVP) (as a surrogate of RAP) and the VP during a fluid challenge.

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Available abstract

According to Guyton, the difference between mean systemic filling pressure (Pms) and right atrial pressure (RAP) is the venous pressure gradient (VP). This is proportional to venous return and cardiac output (CO). According to the Frank-Starling law a fluid challenge successfully increases the stroke volume if the preload increases in the ascending part of the curve. The aim of this study was to assess the significance of the analogue of the Pms (Pmsa) measured with the Navigator™ (Applied Physiology, St Leonards, Australia), the central venous pressure (CVP) (as a surrogate of RAP) and the VP during a fluid challenge.

Key concepts: Preload, Starling, Central venous pressure, Medicine, Venous return curve, Stroke volume, Cardiac output, Mean circulatory filling pressure

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