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Fick Cardiac Output

Fick Principle: The gold standard for measuring cardiac output based on oxygen consumption and arteriovenous oxygen difference.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

When to Use

Evaluation of hemodynamics during Right Heart Catheterization (RHC).
Quantification of cardiac output (CO) and cardiac index (CI).
Assessing shock states and guiding inotropic/vasopressor therapy.

How it Works

The Fick Principle

The Fick principle states that the uptake of a substance by an organ is the product of the blood flow to the organ and the arteriovenous concentration difference of the substance. In cardiology, this is applied using oxygen consumption (VO2).

Formula

CO = VO2 / [13.4 × Hgb × (SaO2 − SvO2)] Where VO2 is oxygen consumption (typically estimated as 125 mL/min/m2 or using the LaFarge formula).

Clinical Pearls

Estimated vs. Measured VO2

Most labs use "Estimated Fick" where oxygen consumption is assumed based on age and sex. This can be inaccurate in patients with severe obesity or thyroid disease. "Measured Fick" (using a metabolic hood) is the gold standard.

Next Steps

Complementary Calculators

Cardiac Output Index
SVR Calculator
PVR Calculator
MAP Calculator
Stroke Volume Index

The Evidence

Foundational Principle

Uber die Messung des Blutquantums in den Herzventrikeln.

Fick A. • Sitzungsberichte der Physikalisch-Medizinischen Gesellschaft zu Würzburg.. 1870;The original description of the Fick principle.

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

When to Use

Evaluation of hemodynamics during Right Heart Catheterization (RHC).
Quantification of cardiac output (CO) and cardiac index (CI).
Assessing shock states and guiding inotropic/vasopressor therapy.

How it Works

The Fick Principle

The Fick principle states that the uptake of a substance by an organ is the product of the blood flow to the organ and the arteriovenous concentration difference of the substance. In cardiology, this is applied using oxygen consumption (VO2).

Formula

CO = VO2 / [13.4 × Hgb × (SaO2 − SvO2)] Where VO2 is oxygen consumption (typically estimated as 125 mL/min/m2 or using the LaFarge formula).

Clinical Pearls

Estimated vs. Measured VO2

Most labs use "Estimated Fick" where oxygen consumption is assumed based on age and sex. This can be inaccurate in patients with severe obesity or thyroid disease. "Measured Fick" (using a metabolic hood) is the gold standard.

Next Steps

Complementary Calculators

Cardiac Output Index
SVR Calculator
PVR Calculator
MAP Calculator
Stroke Volume Index

The Evidence

Foundational Principle

Uber die Messung des Blutquantums in den Herzventrikeln.

Fick A. • Sitzungsberichte der Physikalisch-Medizinischen Gesellschaft zu Würzburg.. 1870;The original description of the Fick principle.

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

JAMAJul 21, 2026
Errors in Figures

Clinical Context

We think this might be relevant to the clinical guidance for Fick Cardiac Output.

WHO NewsJul 20, 2026
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Clinical Context

We think this has broad domain relevance to Fick Cardiac Output.

WHO NewsJul 15, 2026
New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

Clinical Context

We think this has broad domain relevance to Fick Cardiac Output.