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Flashcards in Pulmonary Artery Catheter Deck (17)
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1

Indications for PAC?

Assess volume status Assess RV/LV failure Assess Pulm HTN Assess valvular disease Cardiac surgery

2

Where is CVP measured?

proximal port of PAC in superior vena cava or in R atrium (CVP = RAP)

3

Where/how is Pulmonary Artery Pressure measured? What does it reflect?

At the tip of the PAC with balloon deflated. Reflects RV function, PVR and LA filling P

4

Where/how is Pulmonary Capillary Wedge Pressure measured?

At the tip of the PAC catheter with the balloon inflated

5

PAC has a thermistor for temperature measuring, also a port for CVP measuring. Y/N?

Y and Y

6

Continuous pressure monitoring during PAC insertion is required to determine location of the catheter tip. Y/N?

Y

7

When should you inflate the balloon?

when the 20cm mark is at the hub of the introducer.

8

How far should you insert the PAC?

Advance the PAC until the pulmonary capillary wedge pressure (PCWP) is obtained, usually around 45-55cm at the hub.

9

Understand the change of pressure wave forms as you advance the catheter

10

Get yourself familiar with these values

11

What’s the oxygen delivery equation? 

DO2=CO/BSA*CaO2; (CO/BSA=CI, cardiac index)

12

What’s Mixed Venous Oxygen Saturation (SVO2) and what’s it used for

Oxygen saturation in pulmonary artery blood; Used to detect impaired tissue oxygenation

13

What’s Oxygen uptake and its equation? 

Rate of oxygen taken up from the systemic microcirculation; VO2 = CI x 1.34 x Hgb x (SaO2 - SVO2)

14

Benefits from PAC? 

Effect on Treatment Decisions: information gathered from PA catheter data can beneficially change therapy;

Preoperative Catheterization: information gathered prior to surgery can lead to cancellation or modification of surgical procedure, thereby preventing morbidity and mortality;

Perioperative Monitoring: provides invasive hemodynamic monitoring in the surgical setting

15

PAC complications during establishment of central venous access?

Accidental puncture of adjacent arteries; Bleeding; Neuropathy; Air embolism; Pneumothorax

16

PAC complications during advancing the catheter? 

Dysrhythmias; Premature ventricular and atrial contractions; Ventricular tachycardia or fibrillation; Right Bundle Branch Block (RBBB); In patients with preexistinh LBBB, can lead to complete heart block; Minor increase in tricuspid regurgitation 

17

PAC complications when encountered catheter residence? 

Thromboembolism; Mechanical, catheter knots; Pulmonary Infarction; Infection, Endocarditis; Endocardial damage, cardiac valve injury; Pulmonary Artery Rupture 0.03-0.2% incidence, 41-70% mortality