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

Flashcards in Arterial Lines Deck (24):
0

Mean pressure in NIBP corresponds to

Point of maximal oscillations
Systolic and diastolic are calculated

1

NIBP diastolic pressure is measured where oscillations become

Attenuated (weakened)

2

What are the components of IBP?

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

3

NIBP often over estimates

Low BP

4

What is Fourier Analysis?

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

5

What two waves make up ABP waveform?

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

6

During systole, the ________ ejects blood
Followed by peripheral arterial run off during _______

Left ventricle, diastole

7

Review the graph of ABP relation to EKG

Do it

8

Indications for ABP

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

Absolute contraindications to ABP

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

10

Relative contraindications to ABP

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

11

Where should the transducer be placed?

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

12

The most common site of cannulation is the

Radial artery

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

13

How does distance affect waveform?
Pulse pressure _______
MAP ______
The waveform _______
________ in arrival of pulse at periphery

Widens
Decreases
Narrows
Delay

14

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

Physical characteristics of vascular tree (impedance and harmonic resonance)

15

The elderly have _______ arterial distensibility

Reduced

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

16

How is myocardial oxygen balance affected in the elderly?

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

17

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

Negative
Should not be punctured

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

18

How is the transfixation technique different from direct cannulation?

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

19

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

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

20

If the bed is raised, the measured ABP will be

Higher
Difference equal to the hydrostatic pressure difference between the two transducers

21

If a pressure waveform is dampened, the MAP

Remains unchanged

22

Complications of ABP

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

23

What is Vigileo?

Minimally invasive assessment of cardiac function