Advanced Hemodynamic Monitoring Flashcards

1
Q

normal value for cardiac index

A

2.2-4.2 L/min/m2

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2
Q

normal central venous pressure

A

5-12 mm Hg

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3
Q

when is measurement of CVP most accurate ?

A

at end of expiration

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4
Q

coronary perfusion pressure

A

50-120 mm Hg

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5
Q

what is roughly equal to central venous oxygen saturation ? value in awake pt?

A

mixed venous oxygen saturation; 60-80%

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6
Q

value for pulmonary artery pressure

A

15-30/10

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7
Q

values for mild, moderate, and severe pulmonary HTN

A

mild (36-49 mm Hg systolic)
moderate (50-59 mmHg)
severe >60 mm Hg

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8
Q

normal value for stroke volume

A

60-90 mL/beat

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9
Q

normal value for stroke volume index

A

20-65 mL/beat/m2

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10
Q

normal value for systemic vascular resistance

A

700-1200 dynes sec cm -5

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11
Q

normal value for central venous O2 saturation (ScvO2)

A

25-30% below the pt’s SaO2 or 70-75% if the SaO2 is normal

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12
Q

responds to changes in blood pressure

A

baroreceptor reflex

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13
Q

when bp is low , hr ____

A

increases

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14
Q

when bp is high, hr ___

A

decreases

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15
Q

responds to changes in blood volume inside the heart

A

bainbridge reflex

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16
Q

what happens to the bainbridge reflex if right atrial pressure increases bc blood volume in the right atrium increases ?

A

an increased hr and vasodilation (venous pooling in the legs and decreased venous return)

17
Q

what two things will cause an increase in hr?

A
  1. low CVP (thru baroreceptor reflex)

2. high CVP (thru bainbridge reflex)

18
Q

what provides a more accurate interpretation of cardiac output?

A

cardiac index

19
Q

2 equations for coronary perfusion pressure

A
  1. CPP= DBP-LVEDP

2. CPP= DBP-CVP

20
Q

3 ways to estimate left ventricular diastolic pressure

A
  1. LVEDP =left atrial pressure
  2. left atrial pressure= PCWP
  3. PCWP= PA diastolic pressure
21
Q

3 equations to estimate CPP

A
  1. CPP= DBP-CVP
  2. CPP= DBP-PCWP
  3. CPP= DBP- PA diastolic pressure
22
Q

4 steps for the thermodilution technique

A
  1. 10 mL saline is injected to right atrium
  2. this cold fluid travel to the PA where it encounters the thermistor on the swan
  3. the cold fluid is warmed to a degree
  4. the monitor produces a waveform based on how cold the fluid at the thermistor is
23
Q

high cardiac output will cause the thermistor to?

A

gets cold fast but WARMS UP QUICKLY; total area under the thermodilution curve will be LOWER than normal

24
Q

low cardiac output will cause the thermistor to ?

A

stay cold for a longer period; total area under the thermodilution curve will be HIGHER than normal

25
Q

a small thermodilution wave indicates?

A

high cardiac output; decreased area overestimates cardiac output

26
Q

a large thermodilution wave indicates?

A

low cardiac output; increased area underestimates cardiac output

27
Q

what happens if an anesthetist injected the saline too slowly? >4 seconds

A

thermodilution curve would be larger than normal bc blood at the thermistor would stay cold for a longer period which means the cardiac output reading would be underestimated

28
Q

pt has a right to left intracardiac shunt. would thermodilution in this pt lead to overestimation or underestimation of cardiac output?

A

overestimation

29
Q

pt has a left to right intracardiac shunt. would thermodilution in this pt lead to overestimation or underestimation of cardiac output?

A

overestimation

30
Q

pt has a tricuspid regurgitation. would thermodilution in this pt lead to overestimation or underestimation of cardiac output?

A

underestimation

31
Q

refers to oxygen saturation of blood taken from the superior vena cava

A

central venous O2 saturation (ScvO2)

32
Q

where is a mixed venous sample taken from in a pulmonary artery catheter?

A

distal tip

33
Q

mixing of blood in a mixed venous samples comes from what three places?

A

SVC, IVC, coronary sinus