Hemodynamics Flashcards
Central venous pressure (CVP) range?
2-6 mmHg
Right ventricular pressure (RVP) systolic/diastolic Range?
15-25 systolic
0-5 diastolic
Pulmonary artery pressure (PA)
systolic/diastolic
15-25 systolic
8-15 diastolic
PAWP range
8-12 mmHg
Coronary perfusion pressure (CPP)
50-60 mmHg
Cardiac Output Range
4-8 L/Min
Cardiac Index range
2.5-5.0 L/M
The transducer is placed at the _________ ?
Phlebostatic access 4th intercostal space.midaxillary line.
Pic B is an example of an_______ waveform, what causes this?
Underdamped waveform.
extra tubbing or high SVR
Pic C is an example of an_________ waveform. What causes this?
Overdamped waveform.
stiff, blockage, or small air bubbles.
SVR
800-1200 dynes/ sec
In a Swan Ganz the Red port is a _______Port and uses________ of air to inflate or just enough to see a waveform.
Balloon Port
1-1.5ml of air.
In a swan Ganz, the red balloon port must remain_________ for transport.
deflated.
In a Swan Ganz, The Yellow port is the ________ port and has the_______ at the end and is used to obtain a _________sample and for_________.
distal port
transducer
Mix venous gas
Sv02 sample.
Transducing.
In a Swan Ganz cath which 2 ports are not to be used?
Red and yellow with the thermister connector
In a Swan Ganz Cath the Proximal injectate port is________cm from the tip of the cath.
30cm and infusion injectate port is 31 cm from the tip of the cath.
In a Swan Ganz cath which port is used to administer blood, fluids, and meds. and what is the color of the port?
The proximal port
Yellow.
In a Swan Ganz cath there are two black markings
Thin black lines 10cm
Thick black lines 50cm
discribe a pulmonary artery waveform.
has a dicrotic notch on the descending side indicating the closure of the aortic and pulmonic valves.
The waveform sits higher on the screen 15-25 systolic and 8-15 diastolic
Name three types of obstructive shock.
cardiac tamponade. PE. tension pneumothorax. congenital heart
Name two types of cardiac shock.
Left ventricular failure and dysfunction
Name two types of distributive shock
Sepsis, anaphylaxis
Three types of hypovolemic shock?
Loss of volume, burns, hemorrhage
One type of neurogenic shock?
Spinal cord transection
Name three types of dissociative shock.
Co-poisoning, toxic metabolites, methemoglobinemia. G.O.L.D.M.A.R.K
What is the formula for systemic vascular resistance (SVR)?
MAP-CVP/ Cardiac Output X 80=
CO (Q) formula
(SV) X (HR)/ 1000= Cardiac output
CI formula
Q/BSI=
A decrease in CVP ( right atrial ) may indicate?
Hypovolemia
Vasodilation.
Increased CVP ( right atria) may indicate?
RV infarct
tricuspid insufficiency
COPD or any chest issues… pressure in the PA backs up in the RV then Atria.
A low RV may indicate a?
No preload
Vasodilation
An increase in RV may indicate?
RV failure, CHF, pulmonary HTN, and pressures on the PA.
Anacrotic notch represents _______ on the RV waveform.
Atrial kick
Can the (PAP) be used to estimate the wedge pressure?
Yes
The (PAP) indirectly reflects______________?
Left ventricular end diastolic pressure.
Decreased PAP may indicate?
Hypovolemia or vasodilation
A high PAP may indicate?
left atrial or ventricular issues.
mitral valve regurgitation or stenosis.
pulmonary issues, COPD ext
PCWP measures pressures in the?
Left ventricular end-diastolic pressure and Atrial pressure. Also known as a rolling waveform there is no correlation with the QRS.
What causes a low PCWP?
Hypovolemia and Vasodilation.
What causes an increase in PCWP?
LV failure, mitral valve stenosis cardiac tamponade.
What two types of shock are identical in hemodynamic parameters? WHY?
Cardiogenic and Obstructive. The left ventricle is not ejecting blood out and obstructive shock is obstructed not pushing out as well.
What are the hemodynamic parameters in Septic shock?
All parameters are low. There is no SVR due to pro-inflammatory mediators ( infection) causing vasodilation.
What are the hemodynamic parameters in hypovolemic shock?
All are low except for SVR. No circulating volume so all is low and SVR has constricted.
What are the hemodynamics in neurogenic ( distributive ) shock?
All are low and cardiac output ( CI) is normal. The spinal cord is severed and the system is dilated. But there is no fluid loss so CI is normal.
What are the hemodynamic parameters in right heart failure? RHF
Wedge and CVP are opposite. CVP is high wedge is low.
