Know your Numbers
This calculated as HR x SV
What is CO
A normal resting CI is approximately within this range
What is approximately 2.5-4.0 L/min/m2
CVP=18mmHg
What is elevated
CO 5
CI 2.8
SVR 500
MAP 55
What Distributive shock
Patient MAP 58, HR 125, CVP 2, PAWP 5
What is optimize fluid status; Preload
This is CO adjusted for body surface area
what is CI
A commonly accepted normal CVP
What is 2-6 mmHg
PAWP=25
What is Elevated
CVP 6
PAWP 8
CI 1.6
SVR 1800
MAP 62
What is Cardiogenic shock
Patient: MAP 55, CI 3.4, SVR 400
What is give collect Cx, ABX, Fluids, pressors
This pressure reflects left sided filling pressure and is obtained by balloon occlusion of the PA branch
What is PAWP
A commonly accepted normal PAWP
What is 6-12mmHg
CI 1.6 L/min/m2
What is Low CI
CVP 1
PA 10/5
CI 1.2
SVR 2600
Hgb 5
Lactate 7
What is Hypovolemic shock
Patient: CVP 20, PAWP 30, CI 1.5, EF 15%
What is reduce afterload and optimize contractility with an Inotropic agent
This variable represents resistance to blood flow through the systemic circulation
SVR
A commonly accepted normal SVR
What is 800-1200 dyn-s/cm5
SVR=2000 dyn-s/cm5
What is high SVR
CVP 18
PA pressure low to normal
CI 1.5
SVR 2000
Distended jugular Veins with a right heart strain on Echo
What is obstructive shock; PE
Patient suddenly becomes Tachycardic, Hypotensive, and Hypoxic. CVP rises to 18, PAWP remains 7, CI falls to 1.5. What are you thinking and what orders would you expect?
PE, Stabilize ABCs, CT Angio, ECHO, CXR, IR for intervention, Anticoagulation
This pressure reflects right side filling pressure
CVP
A commonly accepted normal SV
What is 60-100 ml/beat
SVO2 48%
What is Low mixed Venous saturation
HR 115
90/70 MAP 66
EF 15%
Creatnine 1.2
Lactate 2
AST/ALT Elevated
Poor Cap Refill and Cool extremities
Cardiogenic shock; Blood pressure is a late sign
ST Elevation in Leads V1-V4 with reciprocal changes. Diaphoretic with N/V. What type of MI and coronary artery are you thinking and what would you expect?
Anteroseptal MI, LAD artery. STEMI Alert, Aspirin, Cath Lab, high risk for shock post angiogram due to MVD