Pulmonary Artery Catheters 3

Question 0

What causes decreased preload?

Answer 0

• hypovolemia

- vasodilation

Question 1

What causes increased preload?

Answer 1

• hypervolemia

- vasoconstriction

Question 2

What causes increased afterload?

Answer 2

• hypovolemia

- vasoconstriction

Question 3

What causes decreased afterload?

Answer 3

• hypervolemia

- vasodilation

Question 4

What pressure determines the preload in the right heart and what is the normal value?

Answer 4

CVP 2-6

Question 5

What pressures determine afterload of the right heart and what are the normal values?

Answer 5

PAP 20-30/6-15

MAP 10-20

Question 6

What resistances determine afterload of the right heart and what are the normal values?

Answer 6

PVR 50-150

PVRI 100-240

Question 7

What pressure determines the preload of the left heart and what is the normal value?

Answer 7

PCWP 4-12

Question 8

What pressures determine the afterload of the left heart and what are the normal values?

Answer 8

BP 120/80

MAP 80-100

Question 9

What resistances determine the afterload of the left heart and what are the normal values?

Answer 9

SVR 900-1300

SVRI -100-500

Question 10

What flows affect the contractility of the left heart and what are the normal values?

Answer 10

CO 4-8
CI 2.5-5
SV 60-130
SI 30-50

Question 11

What affects the contractility/work of the right heart and what are the normal values?

Answer 11

LVSWI 50-60

RVSWI 8-10

Question 12

What are the measured hemodynamic variables?

Answer 12

CVP (RA)
PAPS/D
PCWP
CO
HR

Question 13

What are the derived hemodynamic variables?

Answer 13

CI
SV/SVI/SVR
PAM
PVR/PVRI
LVSWI 
RVSWI

Question 14

What falls under category 1 in the table?

Answer 14

Normal or hyperdynamic state (septic shock)

Question 15

What falls under category 2 in the table?

Answer 15

Fluid overload (normal contractility)

Question 16

What falls under category 3 in the table?

Answer 16

Hypovolemia (hemorrhage) or dehydration

Question 17

What falls under category 4 in the table?

Answer 17

Acute left heart failure (decreased contractility)

Question 18

How do you determine CMO and what is it affected by?

Answer 18

CO = HR x SV
CO = VO2/C(a-v)O2
Affected by circulating blood volume, contractility, valve function, pericardial function, metabolic rate, vascular resistance

Question 19

What causes an increased CMO (up to 5 times normal)?

Answer 19

Increased metabolism
Septic shock
Exercise
Stress
Pregnancy
Intracardiac shunt
Systemic vasodilation

Question 20

What causes a decreased CMO?

Answer 20

Shock
Hypovolemia
Left cardiac dysfunction
Decrease metabolism
Chronic hypotension
Vascular disease
Cardiomyopathies

Question 21

What are the three ways to measure CMO?

Answer 21

Thermodilution
Fick equation
Dilution method echo

Question 22

What causes a decreased preload?

Answer 22

Hypovolemia - sepsis

< 4 CVP and < 6 PCWP

Question 23

What are the treatments for decreased preload?

Answer 23

NSS
Albumin
Whole blood
Ringers lactate
Colloids

Question 24

What causes an increased preload?

Answer 24

Hypervolemia vs failure
> 10 CVP
> 20 PCWP

Question 25

What are the treatments for increased preload?

Answer 25

Diuretics for hypervolemia

Vasodilators, ionotropics, nitroglycerine for failure

Question 26

What are the treatments for decreased afterload?

Answer 26

Norepinephrine
Dopamine
Phenylephrine

Question 27

What are the treatments for increased afterload?

Answer 27

Vasodilators such as sodium nitroprusside

Alpha inhibitors such as clonidine

Question 28

What are the treatments for increased contractility?

Answer 28

Negative ionotropic agents
Propranolol
Diltiazem

Question 29

What are the treatments for decreased contractility?

Answer 29

Digoxin
Dopamine
Dobutamine
Epinephrine
Isoproterenol