Hemodynamic monitoring

Question 1

How to find waveforms on CVP tracing?

Answer 1

Locate “a” wave right after “P” wave on EKG.

Question 2

Where to measure CVP?

Answer 2

Measure at end-expiration at base of “c” wave ,or average of high & low parts of “a” wave.

Question 3

“a” wave on CVP tracing indicates what?

Answer 3

Contraction of Atria against open TV

Question 4

“c” wave on CVP tracing indicates what?

Answer 4

Closure of TV

Question 5

“v” wave on CVP tracing indicates what?

Answer 5

Atrial filling against closed valve during ventricular systole.

Question 6

SVR equation?

Answer 6

80*(MAP-CVP)/CO

Question 7

PVR equation?

Answer 7

80*(mPAP-PAOP)/CO

Question 8

O2 delivery equation?

Answer 8

CI * (1.39HgbSaO2 + 0.003*PaO2)

Question 9

Ddx of large V waves in CVP tracing?

Answer 9

TR, MR, volume overload, VSD

Question 10

CVP tracing in pericardial tamponade?

Answer 10

Prominent X descent, loss of Y descent.

Question 11

Triscupid regurgitation has what effect on calculation of cardiac output?

Answer 11

Makes thermodilution method less accurate.

Question 12

How to calculate stroke volume with POCUS?

Answer 12

Velocity Time Interval (VTI) * Cross Sectional Area

Question 13

Definition of fluid responsiveness?

Answer 13

15% increase in CO in response to 500cc bolus.

Question 14

Effect of positive pressure breath on LV & RV preload?

Answer 14

• Increases LV preload by squeezing both pulmonary artery & vein.
• Decreases RV preload by squeezing vena cavae empty, and increasing pulmonary vascular resistance.

Question 15

PPV associated with fluid responsiveness?

Answer 15

12-15%

Question 16

IVC Collapsibility index associated with fluid responsiveness?

Answer 16

12%

Question 17

PLR hemodynamic changes associated with fluid responsiveness?

Answer 17

10% increase in CO.