## eLibrary – FREE

Build up your eLibrary starting with this gem – great hemodynamic tutorial. Hemodynamics is a huge part of our jobs as respiratory therapists and being proficient is key to being a great practitioner.

Anyone and everyone should get this booklet if you are interested in hemodynamics.

Google search “edwards hemodynamics pdf” and then select the search item I have identified in the inset.

If you go to the Edwards website’s homepage, there are other good booklets for free.

There is a lot of good stuff out there for free from our vendors.

As I have opportunities, I will post them – I will use the key search words eLibrary or FREE so the references can be found.

## Starling Curve – how to “read” / use a Starling curve

The STARLING CURVE :

• describes the relationship between the cardiac ventricle and its potential for ejectability of its volume.
• describes the status of the cardiac sarcomere.

pictured above : the basic / generic curve.

above : how to read : draw a line from the x-axis to the curve.

(more to follow at a later date).

follow the line up to the curve.

once you reach the curve, go directly (perpendicularly) left.

keep going till you hit the y-axis.

read the value on the y-axis (3L/min) – for this patient at this time at this current volume status.

back to the x-axis, start giving 1L of IVF (intravenous fluid) challenge.

based on the units on the x-axis, go to 1L of IVF moreso then before fluid challenge.

follow the line upward … till you hit the curve.

once you hit the curve, go directly (& perpendicularly)  leftward.

read the new value on the y-axis … this is the new cardiac output after getting a 1L IVF challenge.

## Starling Curve – CHF status

This scenario demonstrates the cardiac ventricle’s response to IVF challenge in a heart’s ventricle

that is overfilled.

When you follow the graph through, before vs. after a 1L IVF challenge,

the cardiac output actually gets worse by 1 L/min.

## Starling Curve – dehydration

This shows the response of the cardiac ventricle to IVF challenge in the

dehydrated (underfilled) ventricle portion of the Starling Curve.

The Starling Curve shows that giving 1L  of IVF results in a significant  increase in

cardiac output by 2 L/min.