Cardiac Output Monitoring

Question 1

On a Swan-Ganz catheter, the balloon lumen is typically what color?

Answer 1

Red

Question 2

On a Swan-Ganz catheter, the proximal injectate port is typically what color?

Answer 2

Blue

Question 3

Complications of Swan-Ganz catheter?

Answer 3

Air emboli from ruptured balloon
Inflation of the balloon causing rupture of small vessels in lungs
Occlusion of cardiac flow

Question 4

Fick’s Equation

Answer 4

CO = VO2 / (Ca-Cv)

Question 5

Stroke volume = ______ - _____

Answer 5

SV = EDV - ESV

Question 6

Label the following diagram, and the expected pressure ranges for each:

Answer 6

RAP (0-10)
RVP (15-25 sys, 0-5 dia, mean 10-15)
PAP (15-30 sys, 8-15 dia, mean 10-20)
PWP (6-12)

Question 7

PWP in ARDS?

Answer 7

<18

Question 8

Explain what these curves are describing

Answer 8

Thermodilution curves:
The ‘contrast’ can be anything, from color (green, etc), or low temperature, etc.
X-axis = time
Y-axis = contrast
The contrast is injected, and the time it takes for the contrast to return to normal blood is the calculated CO. The Cardiac Output is inversely proportional to the area under the curve.

Question 9

List 10 pieces of information that can be gathered from a Swan Ganz catheter?

Answer 9

CVP
RAP
RVP
PAP
PWP
CO
SCVO2
VO2
S(mixed)O2
DO2
RVEDV
SV
SVRI
SVR
CI

Question 10

Why do we want the SGanz sample from pulmonary artery? What is the next best spot?

Answer 10

It’s mixed venous sample, with higher O2 content. Best demonstrates the O2 consumption from the body.

Central venous from a central line can be used. It’s less ideal, since it’s measuring in cranial VC, coming from the brain which has lower oxygen content.