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Principles III > CV monitoring PPT > Flashcards

CV monitoring PPT Flashcards

Josh's guide to Show noodle arms that we are the shit, despite his crappy teaching and awkwardly skinny arms

1
Q

what is SvO2 ( define it)

A

Mixed Venous Oxygen saturation

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2
Q

what does SvO2 represent?

A

the % Hb saturated with O2 in the mixed venous blood

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3
Q

SvO2 demonstrates the balance between oxygen _______ and _______

A

delivery
and
consumption

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4
Q

DO2 stands for what?

A

Oxygen delivery

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5
Q

What is normal DO2?

A

1,000 ml/min

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6
Q

What is the calculation for DO2 (oxygen delivery)?

A

DO2=CaO2 x CO x 10

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7
Q

So what is CaO2?????

A

Arterial O2 Content

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8
Q

What does CaO2 mean

A

the total amount of O2 in arterial blood

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9
Q

So how do you calculate CaO2????

A

CaO2= (Hb x 1.36 x SaO2) + (PaO2 x 0.003)

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10
Q

What is the normal range of CaO2?

A

17-20 ml/dl

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11
Q

doing great keep on keeping on

A

Game on folks

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12
Q

What is CvO2?

A

Venous O2 Content

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13
Q

What does CvO2 mean?

A

Total amount of O2 in venous blood

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14
Q

How do calculate CvO2?

A

CvO2= (Hb x 1.36 x SvO2) + (PvO2 x 0.003)

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15
Q

What is the Normal Range of CvO2

A

12-15 ml/dl

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16
Q

It only gets worse from here just hang on you’ll get it!!!!

A

just smile your doing great!!

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17
Q

VO2 stands for what?

A

O2 consumption

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18
Q

what does VO2 mean?

A

amount of O2 consumed by the tissues

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19
Q

the difference b/t the ______ and _____ content will yield O2 consumption (VO2)

A

arterial
and
Venous

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20
Q

what is the equation for VO2? remember the last slide!!!!!

A

VO2= [CaO2 - CvO2] x CO x 10

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21
Q

What is normal O2 consumption (VO2)

A

250 ml/min

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22
Q

What is the “GOLD STANDARD” for CO measurement???? give me the name and formula!!!

A

The Fick method

CO= ( VO2 / CaO2 -CvO2 ) x 100

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23
Q

What things increase preload? (5 things)

A 
Increased ventricular compliance
increased Atrial contractility
decreased HR
Increased Aortic pressure
Increased CVP
--decreased venous compliance
-- increased thorocic venous blood volume
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24
Q

What 2 things increase Afterload

A

SVR (systemic vascular resistance)

PVR (pulm vascular resistance)

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25
Q

What is the calculation for SVR

A

SVR= [ (MAP - CVP) / CO] x 80

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26
Q

What is normal SVR

A

800-1400 dynes/sec/cm^-5

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27
Q

What is the calculation for PVR

A

PVR= [ (MPAP-PAWP) / CO] x 80

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28
Q

What is normal PVR

A

< 250 dynes/sec/cm^-5

29
Q

Lets knock out some easy shit to feel better about life

A

YAAAAAAAAAAAAAAA!!!!

30
Q

I’ll say the problem then you say how to fix it!!!

problem: High preload

A

diuretics

Venodilators

31
Q

I’ll say the problem then you say how to fix it!!!

problem: Low preload

A

Fluids

Vasoconstrictors

32
Q

I’ll say the problem then you say how to fix it!!!

problem: High afterload

A

arterial vasodilators

33
Q

I’ll say the problem then you say how to fix it!!!

problem: low afterload

A

Vasoconstrictors

34
Q

With aortic stenosis what must you do with afterload

A

keep it high

35
Q

I’ll say the problem then you say how to fix it!!!

problem: High contractility

A

Negative inotropes ( need more filling time)

36
Q

I’ll say the problem then you say how to fix it!!!

problem: Low contractility

A

Positive inotropes

37
Q

I’ll say the problem then you say how to fix it!!!

problem: High HR

A

BB

CCB

38
Q

I’ll say the problem then you say how to fix it!!!

problem: Low HR

A

Sympathomimetics

Cardiac pacing

39
Q

What pressures does CVP monitor

A

right heart pressures

40
Q

What are CVP lines (sites) also good for besides monitoring

A

Administer IV fluids

Administer blood products

41
Q

What are cannulation sites for CVP monitoring

A

Femoral vein
Internal jugular
subclavian

42
Q

The _____ _____ is the 1st choice among anesthesia providers for CVP monitoring

A

Internal Jugular

43
Q

what position should pt be in for IJ CVP line placement

A

trendelenburg

44
Q

CVP parallels __ pressures

A

RA

45
Q

CVP monitoring may only be warranted in what pt’s

A

Vasoconstricted trauma pt’s

46
Q

Pulmonary artery catheter is indicated for what type of sx

A

CV and non-CV sx (lol i know dumb ass answer but that is what the slide said)

47
Q

Pulmonary artery catheter is for assessment of what?

A

fluid volume status

48
Q

Pulmonary artery catheter is a ____ _____ balloon tipped catheter

A

Flow directed

49
Q

Pulmonary artery catheter is also used for what type of CO monitoring

A

Thermodilution

50
Q

Pulmonary artery catheter is percutaneous insertion WITH or WITHOUT fluoroscopic assistance?

A

both

51
Q

be very careful placing a Pulmonary artery catheter if the pt has a LBBB! why?????

A

B/c it can cause a RBBB and a complete heart block

52
Q

When doing wedge pressures why don’t you want to inflate the balloon all the way?

A

you may blow the artery!!

53
Q

how much fluid is in the balloon in the Pulmonary artery catheter

A

1.5 ml

54
Q

What are indications for inserting a Pulmonary artery catheter (8 main indications)

A
  • poor LV function
  • Assess IVF volume
  • Evaluate response to fluids/vasoactive drugs
  • Valvular heart disease
  • Recent MI
  • Adult respiratory distress syndrome
  • Massive Trauma
  • Major Vascular sx (Cross clamping Aorta)
55
Q

What occurs with B/P in a normal pt VS mechanically ventilated pt (think pulsus paradoxus)

A

pulsus paradoxus- is the differences in pressures when someone is breathing inspiration on expiration.
-Normally when breathing in pressure drops and when exhaling pressure goes up.
Mechanically ventilated- This is reversed. when inhaling pressure increases and when exhaling pressure decreases

56
Q

with the Vigileo/flo Trac what is the SVV%

A

stroke volume Variation

- a sensitive indicator of preload responsiveness (on control ventilated patients)

57
Q

What does the with the Vigileo/flo Trac SVV% tell you?

A

if the pt needs fluid

58
Q

with the with the Vigileo/flo Trac if the SVV% is high what does that mean?

A

the pt needs volume

59
Q

The highest point in the state of Florida is only ____ feet above sea level.

A

345 feet (115 yards)

60
Q

What does the Vigileo/flo Trac monitor?

A 
CO
CI (cardiac index)
SV (stroke volume)
SVI (stoke volume index)
SVR (systemic vascular resistance)
SVRI (SVR based on BSA)
SVV (stroke volume variation)
ScvO2
(basically CO, SV, SVR, SVV, and ScvO2 and all their indexes)
61
Q

with the Vigileo/flo Trac what are the normal ranges of the parameters?
CO
CI

A

CO: 4.0-8.0 L/min
CI: 2.5-4.0 L/Min/m^2

(key point start with 4 double for CO and 1/2 for CI)

62
Q

with the Vigileo/flo Trac what are the normal ranges of the parameters?
SV
SVI

A

SV: 60-100 ml/beat
SVI: 33-47 mL/beat/m^2
(key point again just half the SV it is not exact but will get you close enough 1/2 60= 30 (33) 1/2 100= 50(47) close enough)

63
Q

with the Vigileo/flo Trac what are the normal ranges of the parameters?
SVR
SVRI

A

SVR: 800 -1200 dynes-sec/cm^-5
SVRI: 1970-2390 dynes-sec/cm^-5/m^2
(no key point i guess you can double it and get close if you want)

64
Q

with the Vigileo/flo Trac what are the normal ranges of the parameters?
SVV

A

<15%

65
Q

with the Vigileo/flo Trac what are the normal ranges of the parameters?
ScvO2

A

> or = 70%

66
Q

What is the name of the monitor that is like the flo trac but non-invasive

A

Reliant non-invasive CO monitor

67
Q

Review

what is the formula for CO

A

CO=SV x HR

68
Q

Review

What is normal CO?

A

5.6 L/min f male
4.9 L/min for a female
(this is resting)

69
Q

Review

how to calculate MAP

A

[ (2 x diastolic) + systolic] / 3

Principles III (24 decks)

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