Hemodynamics

Question 1

effect of PPV on afterload?

Answer 1

decreases LVTM thereby decreasing afterload

Question 2

how does fluid lead to increased contractility?

Answer 2

increase preload leads to increased calcium affinity thereby increasing contractility

Question 3

threshold of PPV to predict volume responsiveness?

Answer 3

> 13%

Question 4

limitations of PPV for volume responsiveness?

Answer 4

sinus rythym, no spont ventilation, no dyssynchrony, TV 8-10cc/kr

Question 5

things that can cause and overdamped a line?

Answer 5

obstruction of tip or hypovolema

Question 6

things that can cause a underdamped a line?

Answer 6

vasocontriction, excessive tube length

Question 7

CVP prominent a wave?

Answer 7

PHTN, tricuspid stenosis

Question 8

CVP prominent v wave?

Answer 8

TR

Question 9

CVP prominent A/V wave?

Answer 9

tamponade, pericarditis

Question 10

CO equation?

Answer 10

MAP-CVP/SVR

Question 11

thermodilution calculation of CO?

Answer 11

AUC using temperature

Question 12

Fick versus thermodiluation of the CO measurement?

Answer 12

Fick more accurate but you need a Vo2 measurement

Question 13

CVP with an IVC <1.5cm?

Answer 13

0-5

Question 14

CVP with an IVC <1.5-2.5 cm with >50% variation?

Answer 14

5-10

Question 15

CVP with an IVC 1.502.5 cm with <50% variation

Answer 15

10-15

Question 16

CVP with IVC >2.5?

Answer 16

15-20

Question 17

why would ET CO2 rise in PLR?

Answer 17

transiently raises venous return thereby increasing Co2 return

Question 18

threshold for ETCO2 rise with PLR?

Answer 18

> 5% inc in ETCO2 predicts increase in CO by 15%

Question 19

when is goal timing for PAOP measurement?

Answer 19

end of exhalation and end of diastole whihc is C wave on waveform and also end of QRS

Question 20

difference of ScVO2 and true mixed venous O2?

Answer 20

ScVO2 is likely higher than true values in shock state

Question 21

why is PLR best test for fluid responsiveness?

Answer 21

can use in any patient

Question 22

positive PLR?

Answer 22

670-90 seconds legs up is equivalent to 150-300 cc bolus

> 10% PP

Question 23

dominant X descent with blunted y descent on CVP?

Answer 23

tamponade

Question 24

steep x and y descent?

Answer 24

pericardial constriction

Question 25

normal RV pressure?

Answer 25

23/8

Question 26

normal PA pressure?

Answer 26

23/6

Question 27

normal PCWP?

Answer 27

6-12