Scribd Logo
Upload

Welcome to Scribd!

  • 9 views

    Copy Monitoring Hemodinamic

    Uploaded by

    warmanlicy
    Hemodynamic monitoring during cardiopulmonary bypass (CPB) measures variables related to blood flow, heart function, and blood vessels. Key variables include stroke volume, cardiac output, systemic and pulmonary vascular resistances, and blood pressures. Monitoring can be invasive via arterial lines and pulmonary artery catheters or non-invasive using pulse oximetry and electrocardiograms. During CPB, hemodynamic values are maintained within normal ranges to optimize oxygen delivery to tissues.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Copy Monitoring Hemodinamic

    Uploaded by

    warmanlicy
    9 views23 pages
    Hemodynamic monitoring during cardiopulmonary bypass (CPB) measures variables related to blood flow, heart function, and blood vessels. Key variables include stroke volume, cardiac output, systemic and pulmonary vascular resistances, and blood pressures. Monitoring can be invasive via arterial lines and pulmonary artery catheters or non-invasive using pulse oximetry and electrocardiograms. During CPB, hemodynamic values are maintained within normal ranges to optimize oxygen delivery to tissues.

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Hemodynamic monitoring during cardiopulmonary bypass (CPB) measures variables related to blood flow, heart function, and blood vessels. Key variables include stroke volume, cardiac output, systemic and pulmonary vascular resistances, and blood pressures. Monitoring can be invasive via arterial lines and pulmonary artery catheters or non-invasive using pulse oximetry and electrocardiograms. During CPB, hemodynamic values are maintained within normal ranges to optimize oxygen delivery to tissues.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9 views23 pages

    Copy Monitoring Hemodinamic

    Uploaded by

    warmanlicy
    Hemodynamic monitoring during cardiopulmonary bypass (CPB) measures variables related to blood flow, heart function, and blood vessels. Key variables include stroke volume, cardiac output, systemic and pulmonary vascular resistances, and blood pressures. Monitoring can be invasive via arterial lines and pulmonary artery catheters or non-invasive using pulse oximetry and electrocardiograms. During CPB, hemodynamic values are maintained within normal ranges to optimize oxygen delivery to tissues.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 23

    Hemodynamic Monitoring

    During CPB

    Ibnu Sofa S.Kep Ners


    Haemodynamic monitoring is the study
    of how blood flows through
    the cardiovascular system

    3 main object:
    (blood volume,heart and blood vessels).
    Hemodynamic variable

    1
    • Pump
    Systemic

    Circulation 2
    • Resistance
    Pulmonal
    3
    • Pressure
    Hemodynamic Monitoring

    • SVR
    Pressure
    • Stroke Volume • Sistolic • PVR
    Resistance
    • CRT • Diastolic
    Flow
    • MAP
     optimize OXYGEN PERFUSION..
    HEMODYNAMIC MONITORING
    CARDIAC OUTPUT
    Preload..fluid regulation

    1.Baroreceptor reflex
    2.Volume receptors
    3.Renin-angiotensin-aldosterone mechanism
    4.Antidiuretic hormone

    INKAVIN ASAM-BASA [email protected]


    Blood Pressure, Sodium, And Water
    Afterload

    • SVR  left ventrikel afterload


    • PVR  right ventrikel afterload
    Contractility
    • Starling Law’s ()
    • Autonom drugs factor: adrenergic

    Adrenergic

    Alpha-1 Alpha-2 Beta-1 Beta-2 Beta-3

    Vasocontriction Release NE Contarctility Vasodilatation lipolisis


    Contractility
    Heart Rate
    Hemodinamik Monitoring
    During CPB

    1.Invasif
    •arteri line
    •CVP
    •PA
    •Blood gass

    2.Non Invasif
    SaO2, NIRS, BIS, ECG
    ARTERIAL PRESSURE MONITORING

    Arterial Pressure Waveform


    CVP waveform
    3. Pulmonal Arterial Line Monitoring

    PAC Line/ SwanGanz


    Wave pattern RA,RV,PA,PCWP
    During CPB??
    During CPB??
    Hemodynamic value
    MAP, average aortic pressure (Systolic + (Diastolic x2))/: 3 70 – 105 mmHg
    during cardiac cycle DP + 1/3 xPP
    Sistolic pressure 100 – 140 mmHg
    Diastolic pressure 60 - 80 mmHg

    CO: ejection of blood in minute CO = HR x SV 4 – 8 L/menit

    CI : Indeks from CO CO / BSA 2.5 – 4 L / min/m 2

    SV: ejection of blood volume in CO/HR 60 – 100 ml/beat


    each contraction

    CVP, pressure in RA, indication of Measure in proximal PA cath. 2 – 6 mmHg/


    venous return & preload 3-8 cm H2O
    PAP: PA pressure when deflate Measure in distal PA catheter when PAS 15 - 30mmHg
    the baloon , PA diastolic reflect deflate the baloon PAD 5 - 15mmHg
    of LAP and LVEDP

    PAWP/ PCWP , PA pressure when Measure in distal PA catheter when 6 – 12 mmHg


    inflate the baloon, reflect LAP inflate the baloon
    and LVEDP

    SVR, systemic vascular SVR = ( (MAP-CVP) x80 ) : CO 900 – 1400 dyne /sec/cm-5
    resistance, main factor LV
    afterload
    PVR, pulmonal vascular PVR = MPA – PCWP x 80 40 – 150 dynes/sec
    resistance CO /cm -5

    CO x 1,34 x Hb x SaO2 520 – 570 ml/mt/m2


    DO2, Oxygen Delivery
    CO x 1,34 x Hb x (SaO2-SvO2) 110 – 160 ml/mt/m2
    VO2, Oxygen Consumption
    Thank you
    Refferences
    • Alspach. AACN’s Core Curriculum for Critical Care Nursing. Saunders.
    • Berne and Levy. Physiology. Mosby.
    • Hazinski. Manual of Pediatric Critical Care. Mosby.
    • Kinney, Packa, and Dunbar. AACN’s Clinical Reference for Critical Care
    Nursing. Saunders.
    • Kumm. Hemodynamic Monitoring. University of Kansas School of Nursing.
    • Kumm. Intra-arterial Pressure Monitoring. University of Kansas School of
    Nursing.
    • Slota. AACN’s Core Curriculum for Pediatric Critical Care Nursing. Saunders.
    • Taleghani, Fred. Invasive lines, hemodynamic monitoring, and waveforms.
    LPCH, PICU.

    You might also like