Week 12 Handout Swan Ganz Flashcards
What is pulmonary artery pressure monitoring?
It uses a Swan-Ganz catheter to assess pressures in the right heart and pulmonary circulation.
It also provides SvO₂ data to evaluate oxygen delivery vs. demand.
What is the purpose of pulmonary artery pressure monitoring?
To evaluate right and left ventricular function, guide fluid resuscitation, and assess pulmonary vascular resistance and oxygenation status.
What are the indications for pulmonary artery pressure monitoring?
Severe heart failure, cardiogenic shock, cardiac surgeries, pulmonary hypertension, ARDS, and critically ill patients needing precise hemodynamic guidance.
What are the relative contraindications for using a Swan-Ganz catheter?
Left bundle branch block and severe coagulopathy or intracardiac masses.
What are the risks associated with pulmonary artery pressure monitoring?
Arrhythmias, PA rupture, infection, thrombosis, catheter migration.
How is the Swan-Ganz catheter placed?
Inserted via internal jugular or subclavian vein, following the path RA → RV → PA.
Use distance markers (~15 cm RA, ~ 25 cm RV, ~ 35 cm PA) and secure after placement.
What are the key takeaways for confirming catheter placement?
Confirm placement with waveform analysis and/or imaging; avoid deep advancement into smaller PA branches.
What does the RA waveform look like?
Small a, c, v waves (2–8 mmHg).
What does the RV waveform look like?
Sharp systolic upstroke, low diastolic (15–30 / 0–8 mmHg).
What does the PA waveform indicate?
Dicrotic notch = pulmonary valve closure (15–30 / 8–15 mmHg).
What does the PCWP waveform resemble?
Resembles RA, small rounded waves (6–12 mmHg).
What mnemonic helps remember normal PA catheter pressure values?
‘R-2, R-15, P-15, W-6’ for RAP, RVP, PAP, and Wedge/PCWP values.
What is the normal range for SvO₂?
Normal SvO₂ is 65–77%.
What does a low SvO₂ indicate?
Poor cardiac output, hypoperfusion, or shock.
What does a high SvO₂ indicate?
Reduced tissue use, such as in left-to-right shunts, hypothermia, or cyanide toxicity.
What does low PAP & PCWP indicate?
Hypovolemia.
What does high PAP & PCWP indicate?
LV failure or fluid overload.
What does low SvO₂ indicate?
Inadequate oxygen delivery or low cardiac output.
What does high SvO₂ indicate?
Decreased tissue use or high cardiac output states.
What are the advantages of pulmonary artery pressure monitoring?
Direct, real-time data on volume status, cardiac output, and tissue perfusion; guides precise titration of therapy.
What are the disadvantages of pulmonary artery pressure monitoring?
Invasive with risk of complications; noninvasive alternatives include TEE, ECHO, and thermodilution.
What is the primary purpose of Pulmonary Artery Pressure (PAP) Monitoring?
A) To measure left atrial pressure directly
B) To evaluate pulmonary artery function only
C) To assess cardiac function and guide fluid management
D) To measure systemic arterial pressure
Correct Answer: C) To assess cardiac function and guide fluid management
Rationale: PAP monitoring helps estimate left ventricular end-diastolic pressure (LVEDP) and
guides fluid and hemodynamic management, particularly in critically ill patients.
What is the normal range for pulmonary artery systolic pressure?
A) 5–15 mmHg
B) 15–30 mmHg
C) 30–45 mmHg
D) 45–60 mmHg
Correct Answer: B) 15–30 mmHg
Rationale: Normal pulmonary artery systolic pressure ranges from 15 to 30 mmHg, while
diastolic pressure ranges from 5 to 15 mmHg.
Elisha, S., Heiner, J. S., & Nagelhout, J. J. (2023). Nurse A
Mixed Venous Oxygen Saturation (SvO₂) is primarily measured in which location?
A) Right atrium
B) Pulmonary artery
C) Aorta
D) Left ventricle
Correct Answer: B) Pulmonary artery
Rationale: SvO₂ is measured in the pulmonary artery via a fiberoptic pulmonary artery catheter,
as it provides the most accurate assessment of the balance between oxygen delivery and
consumption.
Elisha, S., Heiner,
