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Haemodynamic parameter From Wikipedia, the free encyclopedia
The cardiac index (CI) is a hemodynamic measure that represents the cardiac output (CO) of an individual divided by their body surface area (BSA), expressed in liters per minute per square meter (L/min/m²). This parameter provides a more accurate assessment of heart function relative to the size of the individual, as opposed to absolute cardiac output alone. Cardiac index is crucial in assessing patients with heart failure and other cardiovascular conditions, providing insight into the adequacy of cardiac function in relation to the individual's metabolic needs.[1]
The index is usually calculated using the following formula:[2]
where
The cardiac index is adjusted for body surface area (BSA), typically calculated using the Mosteller formula. This adjustment allows for standardized comparison across individuals with different body sizes, improving the accuracy of CI measurements.[3]
Cardiac index is a critical parameter in evaluating cardiac performance and the adequacy of tissue perfusion. In healthy adults, the normal range of cardiac index is generally between 2.6 to 4.2 L/min/m². Values below this range may indicate hypoperfusion and are often seen in conditions such as heart failure, hypovolemia, and cardiogenic shock. Conversely, elevated cardiac index values may be observed in hyperdynamic states, such as systemic inflammatory response syndrome (SIRS) or in patients with anemia. The cardiac index is thus a valuable tool in guiding therapeutic interventions in various clinical settings, including intensive care units.[4]
In clinical practice, CI helps tailor therapies such as the administration of vasopressors in septic shock based on real-time assessments from tools like bedside echocardiograms. This metric is essential for evaluating heart performance relative to the body’s needs rather than in isolation, making it a key factor in managing various forms of shock.[5]
There are four main types of shock where CI plays a crucial role:[6]
CI is not only important in acute care settings but also in long-term health outcomes. Research, including the Framingham Heart Study, has linked low CI with an increased risk of dementia and Alzheimer’s disease.[7] Additionally, higher CI in organ donors has been associated with improved survival rates in heart transplant recipients.[8]
Cardiac index can be assessed using a variety of methods, which can be broadly categorized into noninvasive imaging and invasive techniques. The choice of method depends on the patient's condition, the specific clinical requirements, and the desired balance between accuracy and procedural risk.[9][10]
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