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Boot Camp Hemodynamic Monitoring

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hemodynamic monitoring
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  Carol Jacobson RN, MN –2010Cardiovascular Nursing Education Associates: www.cardionursing.com 1 NTI 2010Cardiovascular Boot Camp: Hemodynamic Monitoring Carol Jacobson RN, MN Cardiovascular Nursing Education Associateswww.cardionursing.com Function of CV system is to deliver O 2 to tissues HeartArteriesVeinsVolumeLungs job: oxygenate bloodTissues job:extract and use O 2 Hemodynamic monitoring evaluates the ability of CV system to deliver blood flow to tissues:ãDeterminants of COãBlood volumeãVascular tone  Carol Jacobson RN, MN –2010Cardiovascular Nursing Education Associates: www.cardionursing.com 2 Hemodynamic Data:What do we need to know? CO = HR X SVBP = CO X SVR TISSUE OXYGENATION  Most important piece of hemodynamic information is STROKE VOLUME ãAmount of blood ejected with each beat - Normal = 60 –130 ml/beat ãCan’t measure directly invasively or noninvasively  Heart Rate and BP easy to obtain but don’t tell us anything about what’s wrong with the patient  Carol Jacobson RN, MN –2010Cardiovascular Nursing Education Associates: www.cardionursing.com 3 So What We Really Want to Know From Hemodynamic Monitoring is: ãWhat is the stroke volume? ãMust assess determinants of SV to get that information:  – Preload – Afterload – Contractility ãPulmonary artery catheter is an invasive way to get some of this informationãThere are some newer noninvasive methods of obtaining CO that can give us SV but are not widely used at present Invasive Methods of Obtaining Hemodynamic Data  Carol Jacobson RN, MN –2010Cardiovascular Nursing Education Associates: www.cardionursing.com 4 Pulmonary Artery Catheter Distal port Proximal port Cardiac outputconnectionProximal (CVP) tailDistal (PA) tailBalloon port  Pulmonary Artery Catheter ã CVP measures right atrial pressure and is used as a clinical indicator of RV preload - Normal CVP = 2-6 mmHg ã PWP reflects left atrial pressure and is used as a clinical indicator of LV preload - Normal PWP = 8-12 mmHg CVPPWP
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