CVP & PA Catheterization

Question 1

What color is the port used to measure CVP?

Answer 1

Blue

Question 2

What waveform is given when you first enter the RA and is somewhere between 2-10 mmHg?

Answer 2

CVP

Question 3

What waveform is being shown when you pass through tricuspid valve and enter ventricle (waveform does what) ?

Answer 3

Right ventricular pressure (RV pressure)

• Waveform gets much larger to new high point of around 20-24 mmHg

Question 4

What waveform is shown when you pass through pulmonary valve and what does waveform do?

Answer 4

Pulmonary artery Pressure (PA pressure)

– waveform gets smaller again but shifted up the graph to values between 12-24 mmHg

Question 5

What waveform is shown when you occlude (fill balloon) in the pulmonary artery and what does the waveform look like?

Answer 5

PAOP or wedge pressure

– Same lower pressure as PAP pressure but not as great in amplitude

Question 6

What is the normal RVEDP?

Answer 6

0-5 mmHg

Question 7

What is main difference in wedge pressure and PAOP (pulmonary artery occlusion pressure)?

Answer 7

PAOP provides much greater fidelity than wedge pressure because provides much larger cross-sectional area being occluded

Question 8

How much air do you put into a PA balloon when inflating it?

Answer 8

1.5 mL

Question 9

How is the CO affected by slow injection?

Answer 9

Falsely high

Injectate undetected

Question 10

What injection port do you inject through when thermodilution CO measurement is being determined?

Answer 10

Proximal port

Question 11

A Swan-ganz Catheter inserted into a patient with acute respiratory distress syndrome (ARDS) records a pulmonary artery wedge pressure of 6 mmHg. The same pressure would be expected in which other structure?

Answer 11

Left atrium

Question 12

What do the different points of the central venous tracing represent? (ie A C X V Y)

Answer 12

A. Atrial contraction
C. Ventricular contraction
X. Ventricular ejection
V. Venous return
Y. Tricuspid opens

Question 13

How would you confirm tricuspid regurgitation in a patient with a pulmonary artery catheter in place?

Answer 13

By the presence of a CV wave on the CVP tracing. CO will be underestimated.

Question 14

How is the pulse pressure calculated?

Answer 14

Systolic-Diastolic

Question 15

Describe the ECG wave morphology when inserting a CVP catheter into the right atrium?

Answer 15

The presence of biphasic P waves and a CVP measurement between 0-8 mmHg

Question 16

What is the relationship between the Thermodilution curve and cardiac output?

Answer 16

They are inversely proportional (Area under curve decreases = cardiac output increases)

Question 17

If you want to measure the patient’s RVEDP, which port will you transduce? LVEDP?

Answer 17

RVEDP = RAP --- Proximal Port
LVEDP = PCWP --- Distal Port