Arterial Lines

Question 0

NIBP diastolic pressure is measured where oscillations become

Answer 0

Attenuated (weakened)

Question 1

Mean pressure in NIBP corresponds to

Answer 1

Point of maximal oscillations

Systolic and diastolic are calculated

Question 2

What are the components of IBP?

Answer 2

Indwelling catheter
Fluid filled tubing
Transducer (converts pressure to electric signal)

Question 3

NIBP often over estimates

Answer 3

Low BP

Question 4

What is Fourier Analysis?

Answer 4

Summation of sine waves of different amplitudes and frequencies
Reproduces the ABP wave

Question 5

What two waves make up ABP waveform?

Answer 5

Fundamental wave (pulse) and 63% of the second harmonic wave

Question 6

During systole, the ________ ejects blood

Followed by peripheral arterial run off during _______

Answer 6

Left ventricle, diastole

Question 7

Review the graph of ABP relation to EKG

Answer 7

Do it

Question 8

Indications for ABP

Answer 8

Tight, continuous BP control
Hemodynamic instability
Monitoring response to vasoactive drugs
Monitoring safety of anesthetic techniques (deliberate hypotension, CPB)
Prolonged surgical procedures
Frequent ABG sampling
Unreliable NIBP

Question 9

Absolute contraindications to ABP

Answer 9

Localized infection at site of insertion
Preexisting ischemia, nerve damage
Reynaud’s phenomenon (vasospastic disorder)
Traumatic injury proximal to site of insertion

Question 10

Relative contraindications to ABP

Answer 10

Failure to demonstrate collateral flow
Presence of AV fistula in limb
Presence of disrupted lymphatics in limb

Question 11

Where should the transducer be placed?

Answer 11

At the height of the coronary sinus or at the level of EAC during intracranial surgery

Question 12

The most common site of cannulation is the

Answer 12

Radial artery

Others include ulnar, brachial,maxillary, femoral, dorsalis pedis

Question 13

How does distance affect waveform?
Pulse pressure \_\_\_\_\_\_\_
MAP \_\_\_\_\_\_
The waveform \_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_ in arrival of pulse at periphery

Answer 13

Widens
Decreases
Narrows
Delay

Question 14

What causes the difference in waveform that is located more peripherally?

Answer 14

Physical characteristics of vascular tree (impedance and harmonic resonance)

Question 15

The elderly have _______ arterial distensibility

Answer 15

Reduced

Increased pulse pressure, late systolic pressure peak, attenuated the diastolic pressure wave

Question 16

How is myocardial oxygen balance affected in the elderly?

Answer 16

Increased systolic demand and decreased diastolic demand. This means a weakened balance.

Question 17

After releasing pressure on the ulnar artery, no flushing of the hand occurs in 15 sec, this indicates a _______ test and the radial artery should

Answer 17

Negative
Should not be punctured

“Results do not correlate well with outcomes.” WHAT DOES THIS MEAN

Question 18

How is the transfixation technique different from direct cannulation?

Answer 18

The catheter is advanced completely through the artery and then retracted until blood pulsates freely

Question 19

T or F. Leveling is not critical to accurate ABP measurement.

Answer 19

False. EAC or left heart 5 cm below sternum in fourth intercostal space

Question 20

If the bed is raised, the measured ABP will be

Answer 20

Higher

Difference equal to the hydrostatic pressure difference between the two transducers

Question 21

If a pressure waveform is dampened, the MAP

Answer 21

Remains unchanged

Question 22

Complications of ABP

Answer 22

Distal ischemia
Pseudoaneurysm
Arteriovenous fistula
Hemorrhage
Infection
Peripheral neuropathy
Misinterpretation of data
Misuse of equipment

Question 23

What is Vigileo?

Answer 23

Minimally invasive assessment of cardiac function