Shock Flashcards
Central Venous Pressure (CVP)
Where? Measures what?
Normal?
Right atrium Right heart function.
2-8mmHg
What decreases CVP? (2)
Dehydration, distributive shock
What increases CVP? (3)
Cardiac tamponade, fluid overload, cardiogenic shock
Pulmonary Artery Pressure (PAP)
Measures?
Normal
Systolic and diastolic BP in pulmonary artery
15-25/5-15
What increases PAP? (5)
Hypervolemia, pulmonary HTN, LV failure, mitral stenosis or regurgitation
What decreases PAP? (1)
Hypovolemia
Pulmonary Capillary Wedge Pressure (PCWP)
Also called?
Measures?
Normal?
Pulmonary Artery Occlusion Pressure (PAOP)
Left ventricle pressure at end-diastole (maximum stretch)
6-12 mmHg
What increases PCWP? (2)
Increased fluid, decreased elasticity
What decreases PCWP? (1)
Hypovolemia
What does PCWP reflect?
Tendency to develop pulmonary edema
Cardiac Output (CO)
Measures?
Normal
HR x SV Amount of fluid in liters heart pumps out
4-8 L/min
What increases CO? (2)
Inotropic agents, excess fluid
What decreases CO? (2)
Decreased contractility, hypovolemia
Cardiac Index (CI)
Measures?
Normal?
CO/BSA
2.5-4 L/min
Systematic Vascular Resistance (SVR)
Measures?
Normal?
Resistance of systemic circulation against left ventricle
=(MAP-mean CVPx80)/CO
800-1200 dynes/sec/cm-5
Mixed venous oxygen saturation (SVO2)
Measures?
Normal?
Venous O2 by pulmonary artery catheter
60 -80%
What increases SVO2? (4)
Decreased tissue extraction of O2, sepsis, hypothermia, oxyhemoglobin curve to left
What decreases SVO2? (4)
Increased tissue extraction of O2, anemia, fever, increased work of breathing
What is shock?
Clinical syndrome of hypotension, acidemia, and organ hypoperfusion
Hypovolemic shock
Loss of >20% circulating volume (includes DKA)
Cardiogenic shock
Acute pump failure: MI
Distributive shock (3) Types (3)
Vasodilation, reduced PVR, loss of capillary integrity
Septic, anaphylactic, neurogenic
qSOFA (3)
SBP<100, RR>22, GCS<15
Septic shock (distributive)
Hypovolemia d/t altered vascular tone
