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Technology > Hemodynamics > Flashcards

Hemodynamics Flashcards

1
Q

HD instability is a mismatch

A

between 02 delivery and demand

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2
Q

CO=

A

SV x HR

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3
Q

Normal CO/CI

A

CO: 4-8
CI: 2-4

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4
Q

normal SvO2

A

60-80% mixed venous saturation

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5
Q

Normal CVP

A

2-8 (central venous pressure)

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6
Q

Normal PAP

A

20-25/8-10 (pulmonary artery pressure)

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7
Q

Normal PCWP

A

4-12

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8
Q

Normal SVR

A

900-1400 (systemic vascular resistance)

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9
Q

Normal PVR

A

150-300 (pulmonary vascular resistance)

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10
Q

Normal ScVO2

A

70% subclavian venous saturation

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11
Q

Beta 1

A

acts on the heart, agonist, increase chronotropy (HR) and inotropy (contractility)

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12
Q

Beta 2

A

acts on bronchioles/blood vessels- agonist- vasodilator

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13
Q

Alpha 1

A

works on blood vessels- agonist- vasoconstrictor

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14
Q

Dopaminergic 1, D2

A

works on the heart- agonist- increase chronotropy and inotropy

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15
Q

Dopaminergic D4 D5

A

acts on the blood vessels, agonist vasoconstriction

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16
Q

Vasopressin 1

A

acts on the blood vessels agonist causing vasoconstriction

17
Q

causes of inadequate LV filling (preload)

A

tachycardia/dysrhythmias, valvular stenosis, tamponade, pericarditis, hypovolemia

18
Q

causes of inadquate LV ejection (contractility)

A

coronary artery disease: ischemia, infarct causing regional wall motion abnormality, negative inotropes: BB, CCB

19
Q

right ventricular hemodynamic

A

CVP, RAP: normal 2-8

20
Q

left ventricular hemodynamics

A

PCWP/PAD

21
Q

causes of increase in preload

A

bradycardia
tricuspid/mitral valve regurg
hypervolemia

22
Q

cause of decrease in preload

A

tachycardia
tricuspid/mitral valve stenosis
hypovolemia

23
Q

systemic vasodilators; decrease SVR

A
  • ace/arbs
  • hydralazine
  • carvedilol, labetaolol (with alpha receptor antagonistic)
  • nitroprusside
  • calcium channel blockers
24
Q

pulmonary vasodilators; decrease PVR

A
  • nitric oxide; inhaled
  • prostaglandins- inhaled; flolan, velitri, tyvaso
  • phosphodieterase inhibitors- sildenafil, tadalfil (oral)
  • endothelin receptor antagonist (relax vascular in pulmonary bed) : bosenten, macitentan
25
Q

PA catheter uses

A
  • gives information on filling pressures, cardiac function and SVO2 (head and feet)– mixed venous
  • utilized for differentiating shock states
  • titration of IV/inhaled vasodilators for pulmonary HTN
  • after CT surgery or management of cardiogenic shock
  • massive or submassive PE for CDL (catheter directed lysis)
26
Q

Phenylephrine

A
  • alpha 1 adrenergic agonist
  • uses: distributive shock, hypotension with tachycardia
  • good for post anesthesia can give IVP
  • adverse effects: splanchnic hypoperfusion
27
Q

Norepinephrine

A
  • mixed alpha 1 and beta 1 adrenergic agonist
  • uses: distributive shock
  • adverse effects: arrhythmias, peripheral vasoconstriction
28
Q

epinephrine

A
  • mixed alpha 1 and beta 1 adrenergic agonist
  • uses: distributive shock, cardiac arrest, anaphylaxis, heart block, bradycardia
  • adverse effects: splanchnic hypoperfusion, increased myocardial oxygen demand
29
Q

Dopamine

A
  • mixed dopaminergic, beta 1, alpha 1 adrenergic agonist (dose dependent)
  • uses: distributive shock, bradycardia
  • adverse effects: tachycardia, cardiac arrhythmias
30
Q

Vasopressin

A
  • V1 receptor agonist
  • uses: refractory septic shock, GI bleeding, DI
  • adverse effects: splanchic hypoperfusion
31
Q

Dobutamine

A
  • beta 1 adrenergic receptor agonist
  • uses: cardiogenic shock, decompensated HF
    adverse effects: hypotension, increase myocardial oxygen demand
32
Q

Milrinone

A
  • phospdiasterase 3 inhibitor
  • uses: cardiogenic shock, decompensated HF
  • adverse effects: hypotension, thrombocytopenia, arrhythmias
33
Q

isoproterenol

A
  • beta 1 and beta 2 adrenergic receptor agonist
  • uses: bradyarrthymias, AV block
  • adverse effects: hypotension, arrhythmias

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