Pulmonary artery catheter + PAWP

Question 1

Describe the technique of Pulmonary artery catheter to measure PCWP (PAWP)

Answer 1

Insertion of central venous catheter + protruding into RA –> flowating via a balloon at the tip through the RV into the PA

Monitoring during placement:
* Fluoroscopy
* Monitoring the pressure changes as it moves through the chambers/PA

Question 2

Draw the pressure changes from RA up to PCWP

Answer 2

Question 3

List 8 indications for the placement of a pulmonary artery catheter

Answer 3

Determination of:
1. Aetiology of the shock state
2. Cardiogenic vs. non-cardiogenic pulmonary edema

Diagnosis of:
3. Pulmonary hypertension
4. Intra-cardiac shunt

Monitoring of:
5. Oxygen delivery
6. Fluid balance
7. response to vasoactive drugs
8. central temperature

Question 4

List 5 parameters that can be directly measured by a PA catheter

Answer 4

1. RAP
2. RVP
3. PAP
4. PAWP
5. CO

Question 5

List 5 parameters that can be derived va a PA catheter

Answer 5

1. CI
2. SVR
3. PVR
4. DO2
5. VO2

Question 6

List 5 complications associated with the insertion of a PA catheter

Answer 6

1. Arterial puncture
2. Pneumothorax/haemothorax
3. Arrhythmias
4. Air embolus
5. Valvular damage

Question 7

List 5 complicartions associated with a PA catheter in situ

Answer 7

1. Misinterpretation of information
2. Catheter knotting within RV
3. Pulmonary artery rupture
4. Infection
5. Thrombus