Cardiac output is the quantity of blood pumped into

the aorta each minute by the heart. This is

also the quantity of blood that flows through the
circulation. Cardiac output is perhaps the most
important factor that we have to consider in relation
to the circulation.
Venous return is the quantity of blood flowing
from the veins into the right atrium each minute.
The venous return and the cardiac output must equal each other except for a
few heartbeats at a time when blood is temporarily stored in or removed from
the heart and lungs.

Normal Values for Cardiac Output at Rest and

During Activity
Cardiac output varies widely with the level of activity of the body. The following
factors, among others, directly affect cardiac output: (1) the basic level of
body metabolism, (2) whether the person is exercising, (3) the person’s age, and
(4) size of the body.
For young, healthy men, resting cardiac output averages about 5.6 L/min.
For women, this value is about 4.9 L/min.When one considers the factor of age
as well—because with increasing age, body activity diminishes—the average
cardiac output for the resting adult, in round numbers, is often stated to be
almost exactly 5 L/min.
Cardiac Index
Experiments have shown that the cardiac output increases approximately in proportion
to the surface area of the body.Therefore, cardiac output is frequently stated
in terms of the cardiac index, which is the cardiac output per square meter of body
surface area. The normal human being weighing 70 kilograms has a body surface
area of about 1.7 square meters, which means that the normal average cardiac index
for adults is about 3 L/min/m2 of body surface area.
Effect of Age on Cardiac Output. Figure 20–1 shows the cardiac output, expressed
as cardiac index, at different ages. Rising rapidly to a level greater than
4 L/min/m2 at age 10 years, the cardiac index declines to about 2.4 L/min/m2 at
age 80 years. We will see later in the chapter that the cardiac output is regulated
throughout life almost directly in proportion to the overall bodily metabolic
activity. Therefore, the declining cardiac index is indicative of declining
activity with age.

Blood flow through a blood vessel is determined by

two factors: (1) pressure difference of the blood between
the two ends of the vessel, also sometimes called
“pressure gradient” along the vessel, which is the force
that pushes the blood through the vessel, and (2) the
impediment to blood flow through the vessel, which is
called vascular resistance. Figure 14–3 demonstrates
these relationships, showing a blood vessel segment
located anywhere in the circulatory system.
P1 represents the pressure at the origin of the vessel;
at the other end, the pressure is P2. Resistance occurs
as a result of friction between the flowing blood and
the intravascular endothelium all along the inside of
the vessel. The flow through the vessel can be calculated
by the following formula, which is called
Ohm’s law:
in which F is blood flow, DP is the pressure difference
(P1 - P2) between the two ends of the vessel, and R is
the resistance. This formula states, in effect, that the
blood flow is directly proportional to the pressure difference
but inversely proportional to the resistance.
Note that it is the difference in pressure between the
two ends of the vessel, not the absolute pressure in the
vessel, that determines rate of flow. For example, if
the pressure at both ends of a vessel is 100 mm Hg and
yet no difference exists between the two ends, there
will be no flow despite the presence of 100 mm Hg
pressure.
Ohm’s law, illustrated in Equation 1, expresses the
most important of all the relations that the reader
needs to understand to comprehend the hemodynamics
of the circulation. Because of the extreme importance
of this formula, the reader should also become
familiar with its other algebraic forms:
Blood Flow
Blood flow means simply the quantity of blood that
passes a given point in the circulation in a given period