Cardiac Output Calculator (CO / Cardiac Index)
Enter heart rate (HR, bpm) and stroke volume (SV, mL); the tool returns cardiac output CO = HR × SV ÷ 1000 (L/min). Provide body surface area (BSA, m²) and it also computes the cardiac index CI = CO ÷ BSA with a Forrester-style band. Foundational hemodynamic math for emergency medicine, ICU, cardiology and nursing education.
Enter a heart rate (20–250 bpm) and stroke volume (10–250 mL). BSA may be blank or 0–3 m².
Cardiac output (CO)
4.90
L/min (litres per minute)
Cardiac index (CI)
2.58
L/min/m²
Normal (2.2–4.0)
CO = HR × SV ÷ 1000; CI = CO ÷ BSA. Teaching / back-of-envelope figure — does not replace invasive hemodynamic monitoring.
Formula
CO (L/min) = HR (bpm) × SV (mL) ÷ 1000; CI (L/min/m²) = CO ÷ BSA
- · Typical adult resting ranges: CO ≈ 4.0–8.0 L/min; CI ≈ 2.5–4.0 L/min/m².
- · Bedside interpretation uses Forrester bands (1977): CI < 2.2 suggests hypoperfusion / cardiogenic shock; 2.2–4.0 is normal; > 4.0 is hyperdynamic.
- · Gold-standard SV measurements include cardiac MRI, the pulmonary-artery (Swan-Ganz) catheter thermodilution method, and echocardiography (LVOT VTI × CSA).
- · Hyperdynamic states: fever, sepsis, thyrotoxicosis, anaemia, exercise, pregnancy.
- · Low CI causes: post-MI ventricular dysfunction, heart failure, hypovolaemia (preload), pericardial tamponade, severe valvular disease.
- · BSA via Du Bois: BSA (m²) = 0.007184 × W^0.425 × H^0.725 (W in kg, H in cm). This tool assumes BSA is supplied.
- · References: Forrester JS et al., Am J Cardiol 1977; Hurst's The Heart 14th ed.; UpToDate "Hemodynamic basics".
Frequently asked
Why use the cardiac index (CI) instead of just cardiac output (CO)?
Raw CO scales strongly with body size — a 1.5 m² adult and a 2.2 m² adult both at rest will have very different "normal" CO values. Dividing by BSA gives the cardiac index, which is body-size-neutral and can be compared across patients. Almost every ICU and cardiology criterion (Forrester classes, cardiogenic-shock definitions) uses CI rather than CO for that reason.
Is a high cardiac output always a good thing?
No. A high CO / CI is typically the body "forcing" the heart to compensate — for example sepsis (peripheral vasodilation, low SVR), severe anaemia (poor oxygen-carrying capacity), or thyrotoxicosis. Sustained hyperdynamic states can themselves cause high-output heart failure. A resting CI > 4.0 should prompt a search for the underlying driver, not a pat on the back.
Are HR and SV alone enough for bedside use?
The tool is for teaching and back-of-envelope estimates, not monitoring. Real bedside hemodynamic judgement needs: (1) a trustworthy SV measurement (usually echo, Swan-Ganz or a non-invasive CO monitor); (2) context — SVR, PCWP, mixed-venous saturation; (3) dynamic data (exercise or pharmacologic challenges). CO = HR × SV is mathematically exact, but a "bad" clinical CO is often an SV measurement error and needs cross-checking.
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