CARDIAC OUTPUT AND TOTAL PERIPHERAL RESISTANCE IN ANESTHESIOLOGY

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Abstract
Total peripheral resistance is defined and measured in terms of the force required to maintain blood flow from the root of the aorta to the venous exit into the auricles. Observing changes only in blood pressure and heart rate may not suffice in the management of anesthesia for complicated and prolonged operations in "poor-risk" patients. In these difficult situations the most important problems are the prevention and treatment of circulatory derangements. The stroke-volume (pulse-pressure) formulas are ideal for the investigation of problems involving acute fluctuations in blood pressure. The clinical anesthesiologist can estimate cardiac output and total peripheral resistance with ordinary clinical data. The most valuable clinical application of the stroke-volume formulas has been to evaluate and interpret the pressor effect of 90-degree passive elevation of the lower extremities (the "L" position or maneuver). The "L" maneuver is a clinical aid in the management of cardiovascular changes associated with anesthesia.

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