Afterload
Reviewed and revised 12/6/12
- Afterload = left ventricular wall tension required to overcome resistance to ejection (impedance to ejection of blood from the heart into the arterial circulation).
- developed as ventricular muscle fibres shorten during isovolumetric contraction & ejection phases of systole.
DETERMINED BY
- Ventricular size
- Ventricular volume
- Chamber radius
- Wall thickness
- SVR
- Aortic compliance
MANIPULATION IN ICU
- optimal fluid therapy to ensure adequate ventricular size, volume and radius (diastolic volume)
- vasopressors: increase SVR
- vasodilators: decrease SVR
- IABP: decreases afterload
- replacement of aortic valve (emergently)
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC