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ICU Vocab

Things to know with ICU patients

Cardiac Output (CO) Amount of blood ejected from LV per minute. 4-8L/min. HR x SR
Increased CO High circulating volume
Decreased CO Decrease in the strength of ventricular contraction.
Cardiac Index (CI) Amount of blood pumped by the heart, per minute, per meter square of the body.
Decreased CI Pumping ability of the heart to pump effectively is decreased. Not enough blood being pumped to body.
Normal value of CVP 1-6 mmHg
Increased CVP Right sided HF, Volume overload, Tricuspid valve stenosis or insufficiency, Pulmonary HTN, Cardiac tamponade, Right ventriclar infarction.
Decreased CVP reduced circulating blood volume, vasodilation.
Mixed Venous SvO2 = 60-80%
Abnormal Mixed Venous oxygen supply is not sufficient, oxygen demand has increased.
Systemic Vascular Resistance (SVR) The measurement of resistance or impediment o the systemic vascular bed to blood flow
Increased SVR hypothermia, hypovolemia, vasoconstriction, late septic shock
Decreased SVR vasodilation, early septic shock, morphine, nitrates, hypercarbia
Causes of Metabolic Alkalosis loss of hydrochloric acid from vomiting or gastric suctioning. loss of K (diuretic). steroids. hepatic disease. alkali ingestion (Drano, bleach...)
Causes of Metabolic Acidosis Diarrhea, excessive production of organic acids from endocrine disorders, shock or drug intoxication, inadequate excretion of acid from renal disease
Causes of Respiratory Alkalosis hyperventilation, PE, gram-negative bacteremia, Respiratory stimulation by drugs, disease or fever
Causes of Respiratory Acidosis CNS depression from drugs, injury or disease. Respiratory arrest, Hypoventilation from pulmonary, cardiac or neuromuscular disease.
Hypercapnic give oxygen, increase O2 delivery.
Intra-aortic balloon pump (IABP) decreases myocardial workload. increases coronary artery perfusion.
Swan-Ganz catheter Used to evaluate HF, pulmonary hypertension,
Preload Occurs during DIASTOLE. Think "Volume" Reduce with diuretics. Increase with fluids.
Afterload Think "Vessels" Reduce with (Vasodilators) Nitro, Nipride, ACE, ARBs, Beta Blockers, CCBs, Hydralazine, Isosorbide. Increase with (Vasopressors) Levo, Neo, Epi
Contractility Think "Pump" Increase contractility with Dobutamine, Primacor, Dopamine (high dose).
Vasodilators Nicardipine, NTG, Nitroprusside, Hydralazine, Captopril, Enalaprilat, Losartan (Cozaar)
Vasopressors Dopamine, Epinephrine, Norepinephrine (Levophed), Phenylephrine (Neosynephrine), Vasopressin.
Positive Inotropes Dobutamine (Dobutrex), Milrinone (Primacor), Digoxin (Lanoxin)
Beta-Adrenergic Blockers Metoprolol (Lopressor, Toprol XL), Labetalol, Carvedilol (Coreg)
Antiarrhythmics Amiodarone, Adenosine, Atropine, Esmolol (BB), Diltiazem (CCB), Verapamil (CCB), Digoxin, Lidocaine, Magnesium Sulfate
Anticoagulants Heparin, Lovenox, Coumadin
Anti-Platelet Agents Aspirin, Plavix (Clopidogrel)
Measurement of Preload CVP
Measurement of Afterload SVR
Measurement of Contractility CO/CI
Increased Pulmonary Artery Pressure Left sided heart failure, atrial of ventricular septal defects, (increased pulmonary arteriolar resistance) pulmonary HTN, volume overload, mitral stenosis, hypoxia.
Signs of abnormal mixed venous Increased CO and HR. Tissues take more oxygen from arterial blood. Blood flow redirected to where blood is needed the most.
MAP Reflects relationship between CO and SVR, reflects arterial pressure in the vessels perfusing in organs
Low MAP indicates decreased blood flow through the organs
High MAP indicates an increased cardiac workload
PA pressure BP in the pulmonary artery
Increased PA Pressure Left to Right Cardiac shunt, PH, COPD, Emphysema, PE, Pulm edema, LV failure.
Direct Thrombin Inhibitors Argatroban, Pradaxa
S/S of Metabolic Alkalosis Slow breathing, hypertonic muscles, twitching, confusion, tetany, seizures, dizziness, coma (if severe)
S/S of Metabolic Acidosis Fruity breath, headache, lethargy, n/v, ab pain, tremors, confusion, coma (if severe)
S/S of Respiratory Alkalosis Paresthesias, confusion, light-headedness, anxiety, palpitations.
S/S of Respiratory Acidosis EARLY: Tachycardia, Tachypnea LATE: bradypnea, confusion, hypotension, lethargy VERY LATE: Coma
Created by: mlwest130