CO and pressure monitoring

Question 1

What is cardiac index?

Answer 1

An assessment of the cardiac output based on the patient’s size. 2.5-4L/min/m2

Question 2

What are invasive and non-invasive way to measure cardiac output?

Answer 2

• Invasive
  
  • Fick’s equations (Need PAC)
  • thermodilation (PAC)
  • pulse contour analysis (with arterial line
• Non-invasive
  
  • Echo
  • venous O2 sat indirectly trends CO
  • Non-invasive pulse contour analysis

Question 3

What things can I get from an ECHO?

Answer 3

• Ventricular function
• ejection fraction
• shunts
• blood flow
• lesions
• wall motion

Question 4

What are indications for an arterial line?

Answer 4

• Continous BP monitoring
• frequent ABG draws

Question 5

What are the complications of an arterial line?

Answer 5

• Thrombus/embolus
• hematoma formation
• arterial spasm
• hemorrhage
• infection

Question 6

What is an increased BP related to? decreased?

Answer 6

• Increased:
  
  • Increased CO- hypervolemia
  • Vasoconstriction- increased vascular tone, meds
• Decreased:
  
  • decreased CO- hypovolemia, cardiac failure
  • vasodilation- loss of vascular tone, medications, sepsis

Question 7

What is MAP?

Answer 7

• Mean arterial pressure
• the average pressure of blood pushing through the systemic system
• MAP= {systolic(diastolicx2)} divided by 3
• want at least 65
• normal: 80-100

Question 8

What is a dicrotic notch?

Answer 8

It indicates the closure of aortic valve, when ventricular relaxation occurs