Hemodynamic Monitoring

Question 1

Normal hemodynamic values for CVP, RAP, PAOP, etc

Answer 1

CVP: 0-6 mmHg or 0-8 cmH2O
MAP: 70-105 mmHg 
RAP: 0-6 mmHg
PAOP: 4-12 mmHg
PCWP: 4-12 mmHg

Question 2

CVP tracing:

Answer 2

A wave- pressure rise during atrial systole; occurs at time of P-R interval
X descent- pressure fall during atrial relaxation
C wave- slight pressure rise due to bulging of A-V valve during ventricular systole
V wave- pressure rises due to venous inflow into atria while A-V valves are closed
Y descent-pressure fall during passive atrial emptying

Question 3

How to zero an A-line

Answer 3

Place transducer at the level of the phlebostatic axis (right atrium) and balance the transducer to atmospheric pressure.

Question 4

PA tracing and where tip of catheter is located at different intervals

Answer 4

RA: RAP = 0-6 mmHg
RV: RVSP = 15-25 mmHg; RVEDP = 0-6 mmHg
PA: PAWP = 4-12 mmHg

Question 5

Main component of hemodynamic monitoring system

Answer 5

Transducer- converts mechanical energy (BP) into electrical energy (display readout)

Question 6

Upstroke

Answer 6

anacrotic limb; pressure rise due to blood entering vessel from ventricular ejection.

Question 7

Downstroke

Answer 7

dicrotic limb; pressure falls due to blood run-off into capillaries and veins

Question 8

Dicrotic notch

Answer 8

closure of the aortic semilunar valve

Question 9

Normal BP: Systemic

Answer 9

120/80

Question 10

Normal BP: Pulmonary

Answer 10

120/80

Question 11

Increased CVP

Answer 11

increased preload: fluid overload; increased afterload: chronic LVF, cor pulmonale, increased PVR; cardiac tamponade, constrictive pericarditis, RVF

Question 12

Decreased CVP

Answer 12

hypovolemia

Question 13

Increased PCWP

Answer 13

cardiac tamponade, constrictive pericarditis, hypervolemia, LVF

Question 14

decreased PCWP

Answer 14

hypovolemia