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Pass | Grades A+
What is the formula for mean arterial pressure (MAP)? - Answer✔ DBP
+ 1/3 x (SBP - DBP)
What is the normal range for cardiac output (CO)? - Answer✔ 4-8 L/min
What is the normal range for cardiac index (CI)? - Answer✔ 2.5-4
L/min
What complications can occur during central venous catheter
placement? - Answer✔ Pneumothorax, arterial puncture, air or wire
embolism, dysrhythmia, av fistula, pseudoaneurysm
What should you immediately do if a patient receives an air embolus? -
Answer✔ Roll pt to left and trendelenberg to keep air in R atrium or
ventricle, attempt to aspirate air with central venous catheter/pulmonary
artery catheter
Relative contraindications for pulmonary artery catheter placement: -
Answer✔ Left bundle branch block, h/o pneumonectomy
Treatment for hemoptysis after pulmonary artery catheter placement: -
Answer✔ Immediately pull the catheter slightly back and re-inflate the
balloon, increase PEEP to tamponade the bleeding, mainstem intubate
the contralateral lung, attempt may be made to place a fogarty catheter
down the effected side, may need thoracotomy and lobectomy
,What West zone of the lung is the desired location for a pulmonary
artery catheter? - Answer✔ Zone 3 (pressure in pulmonary arteries >
veins > alveoli)
Which portion of the lung has the highest V/Q ratio and which portion
has the lowest V/Q ratio? - Answer✔ V/Q is highest in upper lobes,
lowest in lower lobes
At what point in the respiratory cycle is the PCWP most accurate in a
ventilated patient? - Answer✔ End expiration
At what point in the respiratory cycle is the PCWP most accurate in a
nonventilated patient? - Answer✔ Peak inspiration
What conditions may make the wedge pressure unreliable? - Answer✔
High PEEP
Aortic regurg
Mitral stenosis
Poor left ventricular compliance
Cardiac tamponade
Pulmonary hypertension
ARDS
PTX
Pulmonary artery catheters allow the direct measurement of which
physiologic parameters? - Answer✔ CVP
Right atrial pressure
Right ventricular end-diastolic pressure
Pulmonary artery wedge pressure SvO2
What complications are associated with pulmonary artery catheter
placement? - Answer✔ Arrhythmias/conduction defects
Pulmonary artery rupture
Valve damage
,Pulmonary infarct
Catheter knotting, entrapment
What is the normal range for systemic vascular resistance (SVR)? -
Answer✔ 800-1400 dyn x s/cm^5
What is the normal range for SVR index (SVRI)? - Answer✔ 1500-2400
dyn x s/cm^5
What is the normal range for pulmonary capillary wedge pressure
(PCWP)? - Answer✔ 7-15 mmHg
What is the normal range for central venous pressure (CVP)? - Answer✔
2-6 mmHg
What is the normal range for pulmonary artery (PA) pressure? -
Answer✔ 20-30/6-15 mmHg
When does the balloon from an intra-aortic balloon pump inflate on
ECG? - Answer✔ T wave (diastole)
When does the balloon from an intra-aortic balloon pump deflate on
ECG? - Answer✔ P wave or start of Q wave (diastole)
Indications for intra-aortic balloon pump placement: - Answer✔ Bridge
to heart tx in pt with LV failure
Cardiogenic shock
Percutaneous coronary angioplasty
Post cardiac surgery
Pre-op for high-risk pt (unstable angina and >70% stenosis of main
coronary artery)
Reversible intracardiac mechanical defect complicating infarct
Unstable angina
, Ventricular dysfunction with EF < 35%
Absolute contraindications to intra-aortic balloon pump placement: -
Answer✔ Aortic regurg
Aortic dissection
Severe aortoiliac occlusive disease
Relative contraindications to intra-aortic balloon pump placement: -
Answer✔ Aortic aneurysm
Aortic or aortofemoral grafts
What is the normal range for mixed venous oxygen saturation (SvO2)? -
Answer✔ 70% +/-5%
What is SvO2? - Answer✔ O2 saturation in the right ventricle or
pulmonary artery, serves as a marker for peripheral O2 supply and
demand
What factors influence SvO2? - Answer✔ O2 delivery and extraction
Approximate percentage of CO that goes to the kidney: - Answer✔ 25%
Approximate percentage of CO that goes to the brain: - Answer✔ 15%
Approximate percentage of CO that goes to the heart: - Answer✔ 5%
What is an intra-aortic balloon pump? - Answer✔ Cylindrical balloon
that actively deflates during systole to reduce afterload, actively inflates
during diastole to increase blood flow to coronary arteries, resulting in
decreased myocardial O2 demand and increased CO.