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Absite topic PA Nir Hus
Pulmonary Artery Flow-directed Catheter (Swan-Ganz) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anatomy of the Catheter
Pulmonary Artery Flow-directed Catheter (Swan-Ganz) ,[object Object],[object Object],[object Object]
Pulmonary Artery Flow-directed Catheter (Swan-Ganz) ,[object Object],[object Object],[object Object]
Pulmonary Artery Flow-directed Catheter (Swan-Ganz) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thermodilution Cardiac Output ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mixed venous oxygen saturation ,[object Object],[object Object],[object Object]
 
Floating the Swan ,[object Object],[object Object],[object Object],[object Object]
Floating the Swan
 
 
 
[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
Measured Variables ,[object Object],[object Object],[object Object],[object Object],[object Object]
Calculated Variables ,[object Object],[object Object],[object Object],[object Object],[object Object]
Normal Cardiac Hemodynamics (Adult) Mean Pressure Diastolic pressure Systolic pressure Pressure site 70 – 105mmHg 60 – 90mmHg 90 – 140 mmHg Aorta 2 – 12mmHg 90 – 140 mmHg L ventricle 1 – 12mmHg Pulmonary art wedge 10 – 18mmHg 5 – 15 mmHg 15 – 30 mmHg Pulmonary artery 0 – 8 mmHg 5 – 30 mmHg R ventricle 0 – 8 mmHg R atrium
Normal Cardiac Hemodynamics (Adult) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oxygen Parameters 120-160 ml/min/m sq Oxygen consumption index 200-250 ml/min Oxygen consumption (VO2) 60-80% Mixed venous saturation (SvO2) 95-100% Arterial oxygen saturation (SaO2) 7.38-7.42 pH 22-28mEq/L Bicarbonate (HCO3) 35-45 mm Hg Partial pressure of arterial CO2 (PaCO2) 80-100 mm Hg Partial pressure of arterial O2 (PaO2) Normal Range Parameter
Principal Indications for Swan-Ganz Catheter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypotension Low SVR High SVR High SVR High CI Low CI Low CI Low CVP High CVP Low CVP Vasogenic Cardiogenic Hypovolemic
Shock High SVR High SVR Low VO 2 Normal VO 2 Low CI Low CI High CVP High CVP Cardiogenic Heart Failure
Right Atrial Pressure ,[object Object],[object Object],[object Object],[object Object]
Pulmonary Artery Wedge Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pulmonary Artery Wedge Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Output ,[object Object],[object Object],[object Object],[object Object]
Flick Method  ,[object Object]
The Indicator-dilution Technique ,[object Object],[object Object],[object Object]
Cardiac Output (High) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Output (High) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Output (Low) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Output (Low) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Output (Low) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vascular Resistance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Systemic Vascular Resistance (SVR) ,[object Object]
Cardiac Tamponade ,[object Object],[object Object],[object Object],[object Object]
Treatment of Cardiac Tamponade ,[object Object],[object Object],[object Object]
Shunts ,[object Object],[object Object],[object Object]
Shunts ,[object Object],[object Object],[object Object],[object Object],[object Object]
Left to Right Shunts ,[object Object],[object Object],[object Object]
Right to Left Shunts ,[object Object],[object Object],[object Object]
Complications Associated With venipuncture ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications Associated With Catheter Insertion ,[object Object],[object Object],[object Object],[object Object]
Q1- Conditions necessary for PA pressure to equal L. atrial pressure include all of the following except ,[object Object],[object Object],[object Object],[object Object]
Q2- Before accurate pressure can be obtained with PA cath., the pressure transducer must be calibrated and zeroed to the level of the: ,[object Object],[object Object],[object Object],[object Object]
Q3 - Most common complication associated w/ the passage of a PA cath is: ,[object Object],[object Object],[object Object],[object Object]
Q4 – All of the following values can be derived from direct measurment during blood-gas analysis EXCEPT: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Q5 - The oxyhemoglobin dissociation curve is shifted to the Left by: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Q6 - The oxyhemoglobin dissociation curve is shifted to the Right by: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Q7 – A Swan ganz cath in a 70 kg male was placed through the Left subclavian vein and a wedge pressure is obtained.  The approximate distance into the pt. should be? ,[object Object],[object Object],[object Object],[object Object]
Q8 – Which sample of blood will have the lowest O2 tension ,[object Object],[object Object],[object Object],[object Object]
Q9 – Which sample of blood will have the  highest  O2 tension ,[object Object],[object Object],[object Object],[object Object]

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Nir Hus Absite review q6

  • 1. Absite topic PA Nir Hus
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  • 3. Anatomy of the Catheter
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  • 22. Normal Cardiac Hemodynamics (Adult) Mean Pressure Diastolic pressure Systolic pressure Pressure site 70 – 105mmHg 60 – 90mmHg 90 – 140 mmHg Aorta 2 – 12mmHg 90 – 140 mmHg L ventricle 1 – 12mmHg Pulmonary art wedge 10 – 18mmHg 5 – 15 mmHg 15 – 30 mmHg Pulmonary artery 0 – 8 mmHg 5 – 30 mmHg R ventricle 0 – 8 mmHg R atrium
  • 23.
  • 24. Oxygen Parameters 120-160 ml/min/m sq Oxygen consumption index 200-250 ml/min Oxygen consumption (VO2) 60-80% Mixed venous saturation (SvO2) 95-100% Arterial oxygen saturation (SaO2) 7.38-7.42 pH 22-28mEq/L Bicarbonate (HCO3) 35-45 mm Hg Partial pressure of arterial CO2 (PaCO2) 80-100 mm Hg Partial pressure of arterial O2 (PaO2) Normal Range Parameter
  • 25.
  • 26. Hypotension Low SVR High SVR High SVR High CI Low CI Low CI Low CVP High CVP Low CVP Vasogenic Cardiogenic Hypovolemic
  • 27. Shock High SVR High SVR Low VO 2 Normal VO 2 Low CI Low CI High CVP High CVP Cardiogenic Heart Failure
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Notas do Editor

  1. A
  2. D
  3. D, E
  4. C
  5. A 30% sat
  6. D – 80% sat