Hemodynamic Monitoring Flashcards
Hemodynamic Monitoring Goal
Optimizing oxygen delivery and tissue perfusion
Hemodynamic Monitoring studies relationship between
HR, Blood Flow, oxygen Delivery, Tissue Perfusion
Pressure = …
Pressure = Flow x resistance
Cardiac Output formula
CO = HR x SV
4-8 L/ min
Ejection Fraction
fraction of blood ejected with each beat
60-70% - normal
Preload
Volume of blood in ventricle prior to contraction
Causes of decreased preload
Hypovolemia - less volume can’t stretch
Atrial Arythmias - atria can’t fill
Tachy - decreased filling time
Decreases after load
After load
resistance against flow
Ex- opening door against wind
Causes of increased after load
systemic hypertension
aortic stenosis
coarction of the aorta
Contractility
Force of ventricular contraction
(caused by meds, sympathetic nervous system, increase after load, increase HR)
Arterial BP =
Arterial BP = CO x SVR
Cardiac Index
Index better assessment based on body size
CI = CO / body surface area
Noninvasive Hemodynamic
Blood pressure
Assessment of jugular venous pressure - JVD
Assessment if serum lactate levels (increase lactate indicates bad perfusion)
Invasive Hemodynamic
- ArterialPressure - most accurate
- Pulmonary Artery Pressure - flow catether in pulmonary arteries
- Right arterial pressure - R ♡ function
Level in hemostatic monitoring
4th intercostal , midaxillary line
Arterial Presure monitoring
for hemodynamic ally unstable, frequent lab work, vasoactive agents.
sites : radial artery, brachial, femoral
Allen’s test
test blood flow to hands
Arterial Pressure Monitoring Complications
Thrombosis
Embolism
Hemorrhage
Pulmonary Artery Pressure Monitoring
Reflects L ventricular function
site: subclavian, jugular, femoral vein
measures PA systolic, PA diastolic, Pulmonary artery occlusion pressure
Complication of PA catheter
Infection, Dysrhythmia, Air embolism, Thromboembolism, PA rupture , Pulmonary infarction
Right Atrial Pressure
catheter in R atrium
pressure in R atria
2-6 mm Hg
If you’re concerned about hypovolemia what invasive monitoring
Right atrial Pressure monitoring
Complications of RAP
infection
pneumo
hemo
carotid
heart perforation
dysrhythmia
