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PMI AS > Advanced Hemodynamic Monitoring > Flashcards

Advanced Hemodynamic Monitoring Flashcards

1
Q

Cardiac Index Normal Value

A

2.2-4.2 L/min/m^2

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2
Q

Central venous pressure CVP normal value

A

5-12 mmHg

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3
Q

when is CVP most accurately measured?

A

end of expiration

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4
Q

in what patient position is CVP considered NOT accurate?

A

if a patient is sitting

should be backrest from 0-60 degrees

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5
Q

coronary perfusion pressure normal value

A

50-120 mmHg

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6
Q

mixed venous oxygen saturation (mvO2) normal value

A

60-80% in awake pt

roughly equal to central venous oxygen saturation (ScvO2)

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7
Q

pulmonary artery pressure (PAP) normal value

A

15-30/10 mmHg

not as accurate when sitting

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8
Q

mild pulmonary Htn value of PAP systolic

A

36-49 mmHg systolic

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9
Q

moderate pulmonary Htn value of PAP systolic

A

50-59 mmHg systolic

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10
Q

severe pulmonary Htn value of PAP systolic

A

> 60 mmHg systolic

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11
Q

pulmonary capillary wedge pressure (PCWP) normal value

A

less than 12mmHg

not considered accurate if sitting

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12
Q

PCWP is _____ mmHg less than pulmonary artery diastolic pressure

A

1-4mmHg

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13
Q

pulmonary vascular resistance (PVR) normal value

A

100-300 dynesseccm-5

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14
Q

stroke volume normal value

A

60-90mL/beat

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15
Q

stroke volume index normal value

A

20-65mL/beat/m^2

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16
Q

systemic vascular resistance (SVR) normal value

A

700-1200 dynesseccm-5

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17
Q

central venous O2 saturation (ScvO2)

A

25-30% below patients SaO2

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18
Q

what do the bainbridge and baroreceptor reflex have in common?

A

both control the heart rate

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19
Q

baroreceptor reflex definition

A

responds to changes in blood pressure inside the carotid sinus and aortic arch

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20
Q

bainbridge reflex definition

A

responds to changes in blood volume inside the heart

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21
Q

what are the two things the bainbridge reflex causes if the right atrial pressure increases?

A

increased heart rate

vasodilation (decreasing venous return)

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22
Q

what happens to the heart with a low CVP baroreceptor reflex and high CVP bainbridge reflex?

A

increase in HR for both

23
Q

What does the normal cardiac output values depend on?

A

the size of the patient

24
Q

cardiac index definition

A

allows more accurate interpretation of cardiac output b/c number is not skewed by weight

25
Q

cardiac index equation

A

cardiac output/body surface area

26
Q

assuming two patients are healthy which would differ and which would be the same?
cardiac output
cardiac index

A

cardiac output would differ

cardiac index would be the same

27
Q

Stroke volume index equation

A

=stroke volume/body surface area

28
Q

stroke volume index definition

A

allows more accurate interpretation of stroke volume because the number is not skewed by weight

29
Q

coronary perfusion pressure (CPP) equation 1

A

CPP= DBP-LVEDP

30
Q

how can we estimate LVEDP?

A

because it is roughly equal to systolic pressure in the left atrium (left atrial pressure) which is roughly equal to PCWP

31
Q

coronary perfusion pressure (CPP) equation 2

A

CPP= DBP - CVP

32
Q

what are the 3 estimations for LVEDP

A

~ left atrial pressure (LAP)
~left atrial pressure (LAP) ~ PCWP
~PCWP ~ PA diastolic pressure

33
Q

what are the 3 equations CPP can be estimated by?

A 
CPP= DBP-CVP
CPP= DBP- PCWP
CPP= DBP- PA diastolic pressure
34
Q

what are the four parts to thermodilution technique

A

10mL saline injected into RA (<4sec)
cold fluid travels to thermistor
cold fluid is warmed to a degree
monitor produces waveform based on coldness of fluid

35
Q

high cardiac output thermistor chart

A

get cold fast but warm up quickly

area under curve is lower than normal

36
Q

low cardiac output thermistor chart

A

will stay cold for longer period of time

area under curve is higher than normal

37
Q

a factor that decreases the area under the thermodilution curve will over or underestimate CO?

A

overestimate CO

38
Q

a factor that increases the area under the curve will over or underestimate CO?

A

underestimate CO

39
Q

how is cardiac output related to the area under the thermodilution curve?

A

inversely

40
Q

what would happen if you prolonged the injection time?

A

the curve would be larger than normal which means the cardiac output reading would be underestimated

41
Q

what are the two things that have replaced thermodilution?

A

continuous cardiac output (CCO) pulmonary artery catheters

transesophageal echocardiography TEE

42
Q

central venous O2 saturation where is the blood draw from and with what?

A

oxygen saturation of blood from superior vena cava drawn from the central venous line port

43
Q

which will be lower mvO2 or ScvO2? why?

A

mvO2

because coronary sinus blood is more deoxygenated than other blood

44
Q

what are the three things that make up mvO2?

A

superior vena cava
inferior vena cava
coronary sinus

45
Q

how does mvO2 and ScvO2 relate to low cardiac output?

A

lower mvO2 and ScvO2 bc the blood has more time to become deoxygenated

46
Q

how does mvO2 and ScvO2 relate to high cardiac output?

A

higher mvO2 and ScvO2 bc the blood has less time to become deoxygenated

47
Q

what are the two reasons that ScvO2 and mvO2 are rarely used anymore?

A

requires drawing blood from central line or swan

CO can be estimated by other effective methods

48
Q

Ohms law

A

V= IR

49
Q

what does ohms law describe

A

the factors that affect flow through an electrical circuit

50
Q

V=

A

voltage

MAP - CVP

51
Q

I=

A

current

analogous to cardiac output

52
Q

R=

A

resistance
systemic vascular resistance or
pulmonary vascular resistance

53
Q

applying ohms law to cardiac output 2 equations

A 
CO= (MAP-CVP/SVR) (80)
CO= (PAP-PCWP/PVR) (80)

PMI AS (15 decks)

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