Frank-Starling Law

• Increase in the end-diastolic myocardial fiber length increases the tension of the myocardial fiber

• If ventricular end-diastolic pressure is increased using fluids, stroke volume and cardiac are increased

• Dysfunctional myocardium will require more volume to increase cardiac output that normal myocardium

• Excessive volume can produce decreased cardiac output and then diuretic or vasodilator may be indicated

• Hyperdynamic myocardium will produce a high cardiac output even in a low volume state

• Ventricular compliance affects cardiac output in response to fluids

• Non-compliant or "stiff" ventricle will respond to small increases in fluids

• Extremely compliant ventricles can tolerate large volumes of fluids, and fluid challenges may produce minimal change in output

Frank-Starling Curve.jpg