MindMap Gallery Hemodynamic monitoring
Hemodynamic monitoring content in anesthesiology includes arterial blood pressure (ABP), central venous pressure (CVP), pulmonary artery pressure (PAP), dynamic wedge pressure (PCWP), etc.
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This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
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Hemodynamic monitoring
arterial blood pressure (ABP)
Blood pressure definition: the lateral pressure of blood on the walls of arteries
method
Non-invasive arterial pressure monitoring
Common mistakes
The cuff width is 12~14cm (for children, the upper arm length is 2/3)
Too narrow, too loose, too high
Too wide, too tight, too low
Deflates too quickly, too low
Invasive direct arterial pressure measurement (IBP)
Common puncture sites: radial artery (Allen test), dorsalis pedis artery, brachial artery, femoral artery
Precautions
Pressure difference at different parts
zero point
If the left and right sides are inconsistent, the operation should be performed on the side with higher pressure.
Find the cause in time when the waveform decays
IBP indications
Heart and great vascular surgery
Large hemodynamic fluctuations
heavy bleeding
Various types of shock, severe hypertension, critically ill patients
Intraoperative hemodilution and controlled blood pressure lowering
Arterial blood needs to be drawn repeatedly for blood gas analysis
complication
thrombus
ischemia
hemorrhage hematoma
peripheral nerve damage
fistula
Infect
Aneurysm
Derived indicators
Arterial pressure (ABP): the lateral pressure of blood in an artery on the blood vessel wall per unit area
Systolic blood pressure (SBP): aortic pressure that reaches its highest value during mid-systole
Diastolic blood pressure (DBP): aortic pressure reaching its lowest value at the end of diastole
Pulse pressure (PP)=SBP-DBP
Mean arterial pressure (MAP): the average value of ABP at each moment in a cardiac cycle, = DBP 1/3PP
Influencing factors
full of blood
Prerequisites
heart ejection
Significant impact on SBP, necessary conditions
peripheral resistance
The impact on DBP is obvious and sufficient conditions
Compliance
Significantly important factors affecting PP
heart rate
Significantly affects DBP
Central venous pressure (CVP)
Refers to the pressure in the superior and inferior vena cava in the chest near the entrance of the right atrium, reflecting right ventricular preload.
method
Invasive direct measurement method
Intubation route
internal jugular vein
subclavian vein
external jugular vein
femoral vein
Indications
Critically ill patients with severe trauma, various types of shock, and acute circulatory failure
Long-term infusion or complete parenteral nutrition therapy
Various major surgeries or operations can cause significant changes in hemodynamics
Requires rapid blood transfusion and fluid replenishment
Transvenous pacemaker or floating catheter placement
Peripheral veins are difficult to establish
When blood samples are collected repeatedly through a vein
Precautions
Catheter location
standard zero point
intrathoracic pressure
Pressure measurement system patency
complication
cardiac tamponade
Hemopneumothorax
air embolism
hematoma
Infect
CVP influencing factors
Cardiac Function
Normal→CVP normal
Incomplete→CVP↑
venous return volume
More→CVP↑
Less→CVP↓
blood volume vascular tone
Normal→CVP normal
Contraction→cardiovascular volume↑→CVP↑
venous tone
intrapleural pressure
Pulmonary artery pressure (PAP) and pulmonary artery wedge pressure (PCWP)
Pulmonary artery pressure (PAP)
Pulmonary artery systolic pressure (PASP)
15~28mmHg
Pulmonary artery diastolic pressure (PADP)
15~18mmHg
mean arterial pressure (MPAP)
Pulmonary hypertension can be diagnosed when MPAP exceeds 25mmHg at rest or 30mmHg under dynamic conditions.
Pulmonary artery wedge pressure (PCWP or PAWP)
Concept: After the pulmonary arteriole is wedged to block blood flow, the pressure measured at its distal end
Indications
left ventricular dysfunction
multiple organ failure
high risk surgery
Contraindications
Tricuspid or pulmonary valve stenosis
Right side or right ventricular tumor
Tetrad of Fallot
complication
Arrhythmia
Duct knotted and broken
thrombopulmonary embolism
pulmonary artery rupture
Bleeding
Infect
Clinical application
Assessment of left ventricular preload
for identification
Cardiogenic left heart failure: PAP↑2, PCWP↑
Pulmonary pulmonary hypertension: PAP and PCWP are normal or ↓
Cardiac output (CO)
hemodynamic regulation
preload adjustment
Judged by CVP and PCWP
afterload adjustment
Regulation of myocardial contractility