Indications and Basics
This type of shock is a common indication for using a pulmonary artery catheter. It includes a low CI and high PAOP
What is cardiogenic shock?
This is the preferred vein for PAC insertion due to its straight path to the RA.
What is the internal jugular vein.
The dicrotic notch on the PA waveform represents closure of which valve?
What is the pulmonic valve
What are the 3 hemodynamic components the determine the PA pressure
Most arrhythmias during PAC placement occur when the catheter passes through this chamber.
What is the Right Ventricle.
This is an absolute contraindication to PAC placement. (name one)
What is:
•Tricuspid or pulmonary valve vegetation / endocarditis
•RV or RA mass
These two ports on the PAC are commonly used to measure RAP and PA pressures. (name the colors)
What are the proximal (blue) port (RAP) and disatl (yellow) port (PA pressure)
A wedge pressure of 22 mmHg most likely indicates this condition.
What is elevated left atrial pressure.
Due to left heart failure, aortic or mitral valve disease.
Bonus: What is one reason a falsely elevated wedge pressure could occur?
The Fick equation requires these two oxygen content measurements.
What are CaO₂ and CvO₂?
You can minimize infection risk during PAC placement by placing this apparatus over the catheter.
What is a plastic sheath.
The name for the location located at the fourth intercostal space on the chest, at the mid-anterior-posterior diameter, where the right atrium is thought to be.
This maneuver helps to reference the pressure transducer to atmospheric pressure.
What is zeroing.
Name the 5 components to a right atrial pressure tracing.
What are A, C, and V waves and x and y descent.
PVR is calculated using this formula.
What is (mPAP - LAP)/CO = PVR
This waveform abnormality occurs when there are too many stopcocks or kinks in the tubing.
What is overdamping.
Which early PAC developer performed self-catheterization through the antecubital vein in 1929?
Who is Werner Von Forssmann
Name a reason why a CO measurement might be erroneous using thermodilution.
What is right to left shunt
PAOP is best measured at this point in the respiratory cycle.
What is end expiration
This method of CO measurement represents the gold standard for measuring cardiac output
What is direct Fick.
This serious complication occurs when the balloon is overinflated or remains wedged too long.
What is pulmonary artery infarct.
This value derived from PA pressures helps assess RV function and is calculated as (PASP - PADP) / RAP
What is the PA Pulsatility Index (PAPI)
Which bedside test is used to confirm the accuracy and responsiveness of a pressure monitoring system during hemodynamic assessment?
What is square wave test
In a spontaneously breathing patient, where would one measure the right atrial pressure
What is the a-wave at end expiration (highest point).
This hemodynamic index adjusts cardiac output for body surface area and is a more accurate reflection of cardiac performance across different patient sizes.
What is cardiac index
Patients with this condition are at increased risk of developing a complete bundle branch block during a right heart catheter placement
What is left heart block.