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I&M for Anesthesia - Fall 2013 > Arterial Lines > Flashcards

Flashcards in Arterial Lines Deck (24)
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0
Q

NIBP diastolic pressure is measured where oscillations become

A

Attenuated (weakened)

1
Q

Mean pressure in NIBP corresponds to

A

Point of maximal oscillations

Systolic and diastolic are calculated

2
Q

What are the components of IBP?

A

Indwelling catheter
Fluid filled tubing
Transducer (converts pressure to electric signal)

3
Q

NIBP often over estimates

A

Low BP

4
Q

What is Fourier Analysis?

A

Summation of sine waves of different amplitudes and frequencies
Reproduces the ABP wave

5
Q

What two waves make up ABP waveform?

A

Fundamental wave (pulse) and 63% of the second harmonic wave

6
Q

During systole, the ________ ejects blood

Followed by peripheral arterial run off during _______

A

Left ventricle, diastole

7
Q

Review the graph of ABP relation to EKG

A

Do it

8
Q

Indications for ABP

A
Tight, continuous BP control
Hemodynamic instability
Monitoring response to vasoactive drugs
Monitoring safety of anesthetic techniques (deliberate hypotension, CPB)
Prolonged surgical procedures
Frequent ABG sampling
Unreliable NIBP
9
Q

Absolute contraindications to ABP

A

Localized infection at site of insertion
Preexisting ischemia, nerve damage
Reynaud’s phenomenon (vasospastic disorder)
Traumatic injury proximal to site of insertion

10
Q

Relative contraindications to ABP

A

Failure to demonstrate collateral flow
Presence of AV fistula in limb
Presence of disrupted lymphatics in limb

11
Q

Where should the transducer be placed?

A

At the height of the coronary sinus or at the level of EAC during intracranial surgery

12
Q

The most common site of cannulation is the

A

Radial artery

Others include ulnar, brachial,maxillary, femoral, dorsalis pedis

13
Q
How does distance affect waveform?
Pulse pressure \_\_\_\_\_\_\_
MAP \_\_\_\_\_\_
The waveform \_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_ in arrival of pulse at periphery
A

Widens
Decreases
Narrows
Delay

14
Q

What causes the difference in waveform that is located more peripherally?

A

Physical characteristics of vascular tree (impedance and harmonic resonance)

15
Q

The elderly have _______ arterial distensibility

A

Reduced

Increased pulse pressure, late systolic pressure peak, attenuated the diastolic pressure wave

16
Q

How is myocardial oxygen balance affected in the elderly?

A

Increased systolic demand and decreased diastolic demand. This means a weakened balance.

17
Q

After releasing pressure on the ulnar artery, no flushing of the hand occurs in 15 sec, this indicates a _______ test and the radial artery should

A

Negative
Should not be punctured

“Results do not correlate well with outcomes.” WHAT DOES THIS MEAN

18
Q

How is the transfixation technique different from direct cannulation?

A

The catheter is advanced completely through the artery and then retracted until blood pulsates freely

19
Q

T or F. Leveling is not critical to accurate ABP measurement.

A

False. EAC or left heart 5 cm below sternum in fourth intercostal space

20
Q

If the bed is raised, the measured ABP will be

A

Higher

Difference equal to the hydrostatic pressure difference between the two transducers

21
Q

If a pressure waveform is dampened, the MAP

A

Remains unchanged

22
Q

Complications of ABP

A
Distal ischemia
Pseudoaneurysm
Arteriovenous fistula
Hemorrhage
Infection
Peripheral neuropathy
Misinterpretation of data
Misuse of equipment
23
Q

What is Vigileo?

A

Minimally invasive assessment of cardiac function