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PA catheter

ANP1 Exam 3

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
Created by: girlnamedsharon