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INVASIVE PRESSURE MONITORING. AIM Information concerning cardio respiratory performance and the effects of therapy in critically ill patients. 1. Arterial Blood Pressure Monitoring 2 . Central Venous Pressure Monitoring 3. Pulmonary Artery Pressure Monitoring

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invasive pressure monitoring

INVASIVE PRESSURE MONITORING

AIM

Information concerning cardio

respiratory performance and the

effects of therapy in critically ill

patients

slide2
1. Arterial Blood Pressure Monitoring
  • 2 . Central Venous Pressure Monitoring
  • 3. Pulmonary Artery Pressure Monitoring
  • 4. Intra Cranial PressureMonitoring
  • 5. Intra Abdominal Pressure Monitoring
things needed
THINGS NEEDED
  • 1. PRESSURE TRANSDUCER
  • 2. DOME
  • 3. PRESSURE TUBINGS(arterial extension, 3 way stopcock, syringe)
  • 4. DISPLAYING UNIT
  • 5. TRANSDUCER STAND
  • 6. PRESSURE BAG WITH NORMAL SALINE
  • 7. CATHETER SET
pressure transducer
Pressure transducer
  • Air mineture rugged and disposable device
  • These device can convert the movement of the sensing diaphargm into an electrical signal
pressure tubings
Pressure tubings
  • The catheter and stopcock are normally attached to the flush device and transducer by non elastic pressure tubing
  • Continous flush device-use to fill pressure monitoring system and prevent from clotting into the catheter by continously flushing fluid through the system at the rate of 1 to 3 ml/hr
display
DISPLAY
  • Pressure waveforms are visualised on a calibrated oscilloscope
  • Digital displays provide a simple method for presenting quantitative data from the pressure waveform
calibration
CALIBRATION
  • The accuracy of blood pressure measurement requires an accurate reference point that is the patient mid axillary line
  • Zeroing process is done by closing the patient side and opening the other end of the three way to the atmosphere
  • Now press zero
arterial pressure
ARTERIAL PRESSURE
  • INDICATIONS
  • Routine measurement of systemic blood pressure in icu
  • Multiple blood gas analysis

PREFERABLE SITES

  • Radial,femoral,dorsalis pedis
  • CANNULATION
  • Collateral perfusion can be evaluated by modified allens test
slide11
CANNULE
  • 20G INSYTE (radial)
  • Single lumen 18G seldinger technique (femoral)
  • COMPLICATIONS
  • Infection
  • Thrombosis
  • Digital ischemia
  • Vessel damage
  • Bleeding, Nechrosis, Haemotoma
slide14
Indications 1.fliid administration 2.TPN hypertonic solutions 3.vasoactive infusions 4.monitoring for right atrial pressure(CVP)
  • PREPARABLE SITES 1.Internal jugular 2.subclavian 3.brachial 4.femoral
slide15
COMPLICATIONS 1.At insertion arterial puncture,pneumothorax,haemothorax 2.passage of wire/catheter arrhythmias,perforation of SVC,RA 3.Thrombosis 4.Catheter embolism
slide18
INDICATION
  • Haemodynamic measurement(cardiac output, stroke volume, systemic vascular resistance)
  • Measurement of right heart pressure(RAP,PAP)
  • Acute pulmonary hypertension
  • Pulmonary embolism
  • Cardiac tamponade
  • Estimation or preload/left heart filling(PAOP)
  • Derivation of oxygen variables(VO2,DO2)
slide19
HAEMODYNAMIC MEASUREMENTS 1.CARDIAC OUTPUT a.injectate 10ml 5% dextrose @ room temp b.inject througout the resp cycle c.>3 measurements and ignore values>10% from average 2.DERIVED VARIABLE a.CO/CI and SVR b.PVR(I), SV(I),LVSWI,RVSWI