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PA catheter
ANP1 Exam 3
Question | Answer |
---|---|
LA pressure | correlates with LVP during diastolic filling (w/ normal MV) |
how does LA connect w/ R side of heart | pulmonary vasculature |
correctly wedged PAC | ~isolated from R pressures by balloon inflation ~distal opening exposed only to capillary pressure which is = to LA pressure |
PCWP is indirect monitor | 1. LV fiber length 2. according to Starling's Law, LV function |
PA indications | 1. ↓ LV fx (EF <40% / CI <2) 2. assess fluid status 3. eval response to fluids, pressors, inotropes 4. valve disease, CM, tamponade, HF 5. recent MI 6. ARDS 7. trauma/shock/hemorrhage 8. major vascular surg (cross-clamp) 9. high risk OB 1 |
PA contraindications | 1. complete L BBB (risk of CHB) 2. WPW 3. Ebstein's malformation (risk tachyarrhythmia) 4. nidus of infection in bacteremic pt 5. thrombus formation w/ hypercoagulation pts |
PA insertion | ~thru RIJ ~continuous display of pressures ~recognition of waveforms |
PA complications | 1. Central line complications 2. bacteremia 3. endocarditis 4. thrombogenesis 5. pulmonary infarction 6. PA rupture 7. PA hemorrhage 8. catheter knotting 9. dysrhythmias 10. conduction abnormalities 11. PV damage |
PA duration of catheterization | < 72 (risk of complications increases) |
PA rupture | ~50-70% fatal ~nominal hemoptysis should not be ignored ~prompt placement double-lumen ETT ~maintain adequate oxygenation by unaffected lung |
SV formula | CO x 1000 / HR |
normal SV | 60-90 ml/beat |
SVR formula | (MAP - CVP / CO) x 80 |
normal SVR | 1200-1500 |