HEMODYNAMIC HEMODYNAMIC MONITORINGMONITORING

(Invasive (Invasive Techniques)Techniques)

ObjectivesObjectives

1.Describe the different invasive 1.Describe the different invasive hemodynamic monitoring techniques.hemodynamic monitoring techniques.

2.Explain the purposes and indications 2.Explain the purposes and indications of the different hemodynamic of the different hemodynamic monitoring techniques.monitoring techniques.

3.Set-up a hemodynamic monitoring 3.Set-up a hemodynamic monitoring line.line.

4.Identify the different hemodynamic 4.Identify the different hemodynamic wave- forms.wave- forms.

ObjectivesObjectives5. Correlate hemodynamic parameters 5. Correlate hemodynamic parameters

with the clinical manifestations of the with the clinical manifestations of the patient.patient.

6. Provide appropriate nursing 6. Provide appropriate nursing interventions before, during and after interventions before, during and after hemodynamic monitoring.hemodynamic monitoring.

7. Identify the complications of each of 7. Identify the complications of each of the hemodynamic monitoring the hemodynamic monitoring techniques.techniques.

8. Troubleshoot problems encountered 8. Troubleshoot problems encountered during hemodynamic monitoring.during hemodynamic monitoring.

HEMODYNAMIC MONITORING – is the direct measurement of blood pressure inside the veins, heart and arteries. It also include the measurement of circulating blood flow and the amount of oxygen in the blood.

Why hemodynamic monitoring…..

To recognize small changes in the heart function and allows proper or immediate treatment to be started…

Then it prevents complications…..

Hemodynamic Procedures - invasive diagnostic tools to assess the circulatory status or cardiac function of the critically ill patient.

Diagnostic Tools

I - Central Venous PressureII - Pulmonary Artery PressureIII - Intra-arterial Blood Pressure

Components of the Hemodynamic Monitoring System

- Invasive catheter and tubings

- Transducer

- Amplifier / recorder

Hemodynamic Pressures and ValuesHemodynamic Pressures and Values

Central VenousPressure (CVP)or Right AtrialPressure

Pressure createdby volume in theright side of theheart

2-6 mmHg5-12 CmH2O

RightVentricularPressure (RVP)

Pulsatilepressure in theRV

20 – 30 mmHg0 – 5 mmHg

PulmonaryArtery Pressure(PAP)

Pulsatilepressure in thePA

20 – 30 mmHg5 – 10 mmHg

Hemodynamic Pressures and ValuesHemodynamic Pressures and Values

PulmonaryCapillaryWedge Pressure(PCWP)

Pressure createdby volume in theleft side of theheart.

5 – 12 mmHg

Cardiac output(CO)

Amount ofblood pumpedout by theventricle

4 – 6 L/m

Cardiac Index(CI)

CO based onbody size

2.2-4.0L/min/m²