Critical Care: Hemodynamics

HEMODYNAMIC MONITORING: BASIC SETUP
Hemodynamic monitoring measures the oxygenation, flow and pressure of the cardiovascular system. Data obtained helps to assess trends over time concerning the patient’s fluid volume, response to cardiovascular medications and improvement of therapy.

PRINCIPLES
Referencing
 is the positioning of the pressure transducer so that it is at the level of the heart
Phlebostatic Axis is the landmark for referencing of the pressure transducer at the 4th intercostal space, midchest

Zeroing is the confirmation of the pressure within the system; procedure: open stopcock to off TO the patient and observe the monitor for a reading of zero. Zeroing is typically performed at the beginning of the shift, when the validity of reading is questioned or after position changes.

HEMODYNAMIC PARAMETERS [THERAPEUTIC VALUES] 
Preload:
Central Venous Pressure (CVP) or Right Atrial Pressure (RAP) [2-8 mmHg] 
Pulmonary Artery Wedge Pressure (PAWP) or Left Atrial Pressure (LAP) [6-12 mmHg]
Pulmonary Artery Pressure (PAP) [4-12/25 mmHg] 

Afterload:
Systemic Vascular Resistance (SVR) [800-1200 dynes]
Pulmonary Vascular Resistance (PVR) [<250 dynes]

Other:
Stroke Volume (SV) [60-150 mL/beat]
Cardiac Output (CO) [4-8 L/min]
Cardiac Index (CI) [2.2-4 L/min/m2]

Arterial Hemoglobin Oxygen Saturation [95-100%]
Venous Hemoglobin Oxygen Saturation [70%]

 

Image Sources: #1, #2.
Content derived from Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 8th Edition
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: