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Frank-Starling plateau — FRCA Primary MCQ

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ModeratePhysiologyFrank-Starling plateauFRCA Primary

After induction, a patient receives repeated fluid boluses for hypotension, but stroke volume no longer rises and airway pressures increase. Which concept best explains this?

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Correct answer: C — Operating on the flat part of the Frank-Starling curve

The Frank-Starling relationship has a plateau where further preload produces little increase in stroke volume and may cause congestion. Increased contractility would shift the curve upward rather than explain failure to respond to fluid. Reduced pulmonary venous pressure and improved compliance would not produce rising airway pressures. Dynamic assessment of fluid responsiveness is preferable to repeated empiric boluses.

Reference: Ganong Review of Medical Physiology; Primary FRCA physiology texts