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Hemo and SleepStudy

hemodynamics and a little sleep

What is Preload? Myocardial fiber length at end diastole
What is Afterload? total force opposing ventricular ejection
What is Contractility and how does it affect Preload and Afterload? Force of ventricle contraction on each breath cycle, venous return will decrease
What pressures best represent the four areas of the heart? RA – CVP/RV – PVR/ LA – PCWP/ LV - Qt (SVR)
Calculation and range of CVP obtained via central catheter; normal range = 2-6 mmHg / 4-12 cmH2O
Calculation and range of MPAP Systole + Diastole (2)/3; normal range = 12 – 18
Calculation and range of PVR MPAP – PCWP/Qt x 80; normal range = 90-250 dynes
Calculation and range of PCWP obtained via Swan-Ganz; normal range = 4-12 mmHg
Calculation and range of MAP systole + diastole (2)/3; normal range = 70-100
Calculation and range of Qt = SV x f; normal range = 4 – 8 L/min
Calculation and range of SVR = MAP – CVP/Qt x 80; normal range = 800 – 1600 dynes
What does and ↑ or ↓ in CVP represent? ↑ Fluid overload, L-R shunt, Cor pulmonale, + an ↑in PVR see PVR; ↓ Hypovolemic Shock
What does and ↑ or ↓ in PAP represent? ↑ Hypervolemia, Pul. HTN, Pul. Emboli, hypoxiema, LVF; ↓ hypovolemia
What does and ↑ or ↓ in PVR represent? ↑ w/ cor pulmonale, hypoxia, pul. HTN, PE
What does and ↑ or ↓ in PCWP represent? ↑ cardiac tamponade, hypervolemia, LVF, Mitral regurg.; ↓ hypovolemia
What does and ↑ or ↓ in SVR represent? ↑ (vasoconstriction) HTN, Hypovolemia; ↓ (vasodilation) vasodilator therapy, shock
RHF vs. Cor Pulmonale (Causes and Diff.?) Cor Pulmonale is a pulmonary problem therefore an ↑ in PVR is seen, RHF the PVR is normal.
CHF; what happens in it’s most severe state? Where the LHF leads to a RHF, which is hard to diagnose due to false apparnent improvement
Pul Edema vs. Non Cardio Pul. Edema (ARDS) PCWP > 12 is Non-Cardiogenic Pulmonary Edema (ARDS); PCWP > 18 is Cardiogenic Pulmonary Edema (CHF)
Dicrotic notches in catheter waveforms represent closure of what valves? Aortic semi-lunar valve (A-line); Pulmonic semi-lunar valve (Swan-Ganz)
Arterial Line (aortic) continuously monitors BP from intra-arterial
PAC/ Swan-Ganz (pulmonic) provides rapid, beat to beat information of hemodynamic status. (PCWP)
What are the 3 main catheters used for pressure readings? Complications? Type of Blood? 1. A-lines 2. CVP lines 3. Swan-Ganz
Complications of the 3 main catheters? 1. A-line = hemorrhage, embolism, infection 2. CVP lines = arrhythmias, perforation of chamber 3. Sw-Gz = insertion trauma (pneumo), arrhythmias, embolism, infection, art. damage
Type of blood surrounding the 3 main catheters? 1. A-line = arterial 2. CVP lines = Mixed Venous 3. Sw-Gz = Mixed Venous
Polysomnography is the study of what? the polygraphic recording during sleep of multiple physiologic variables related to the state and stages of sleep to assess possible biological causes of sleep disorders.
EEG’s purpose? measures brain waves to determine state of sleep
Sleep Stages? Stage one: drowsiness. Stage two: Light sleep. Stage three and four: Deep sleep (blood pressure & body temperature decrease). REM (active sleep – brain rejuvenation)
REM? Comprises about 25% of sleep time (4 – 6 stages per night). Active phase of sleep where Breathing becomes irregular, Eyes move rapidly, Body twitches and Heart rate becomes irregular. Most large muscle are nearly paralyzed.
What is considered sleep apnea and what are the different types? interruption of breathing during sleep.
Central Sleep Apnea? no chest movement w/o nasal flow
Obstructive Sleep Apnea? chest movement w/o nasal flow
Narcoleptic Sleep Apnea? disturbed nocturnal sleep and an abnormal daytime sleep pattern, characterized by excessive daytime sleepiness (EDS)
Capnography is the study of what? study of the body’s CO2 levels (i.e. to prevent hypoxia)
Describe a waveform of an esophagus intubation. waveform would be rounded and slowly dissipate.
Describe a waveform of hypercapnea. waveform would show a square-ish shape that would steadily enlarge
How does Deadspace relate to capnography? Capnography provides information about CO2 production, pulmonary perfusion, alveolar ventilation (i.e. deadspace), respiratory patterns, and elimination of CO2
Deadspace equation?
What is a colorimetric capnometer? device that is used to verify placement of ET tube, Starts purple and should turn to gold if CO2 is present.
Pulse Oximeter usages and factors that interfering? SpO2, things that may interfere is poor perfusion in peripheral areas, movement, nail polish, etc..
What does a co-oximeter analyze? SaO2 (via ABG analysis)
Sanz electrode measures? pH
Severinghouse electrode measures? CO2
Clark electrode measures? O2
How is a TCM used and what does it analyze? Used to measure O2 and CO2 in infants.
What is third spacing? Veins have a higher osmotic pressure (i.e. “Vampire Veins”), osmotic meaning they suck in fluids and whatever they can’t get the lymphatic sys grabs and if it’s overwhelmed it enters the interstitial space (i.e. 3rd space).
Created by: dennison51801