Please enable JavaScript.
Coggle requires JavaScript to display documents.
Cardiac Output Monitoring - Coggle Diagram
Cardiac Output Monitoring
Classification
Non-invasive
Transthoratic impedance
Transthoratic Echo
Minimally Invasive
PICCO
Pulse contour analysis
LIDCO
Pulse contour analysis
FloTrac
Pulse contour analysis (non calibrated)
Transoesophageal echo
Invasive
Pulmonary artery catheter
Distal lumen (Yellow)
PA
Measures PCWP
Mixed venous samples
Proximal (blue)
30cm
CVP
Cold injection port for thermister
Extra injection port (White)
Thermister
3.7cm from tip
Balloon valve
Derived using Stewart Hamilton equation
8Fr 110cm long
Oesophageal Doppler
Probe
Markers
35,
40,45cm
ODM
posterior towards descending aorta
90cm long
Doppler
Blue Away
Red Towards
Assumptions
Angle constant
Aortic CSA constant throughout cardiac cycle
Laminer flow
70% CO enters descending aorta
Trials
ARISE
ProCESS
ProMISE
Pulse wave Analysis
PICCO
Thermister
Needs CVC
Wesseling algorithm
LIDCO
0.5-2mls Li
Via cannula
Variations in pulsatility proportional to SV
Basleine voltage Na
Change in voltage produces [LI]/time curve
Blood flow = plasma flow/(1-Hct)
Affected by NMBA
IABP
Equipment
Helium Low density
Inflate in diastole
ECG T wave
Arterial wave form
dichrotic
notch
Augmented Pressure
systolic
<diastolis
Indications
Cardiogenic shock
refractory angina
Weaning from cardiopumonary bypass
Contraindications
Aortic regirgitation
AAA
Aortic disection
Peripheral vascular disease
Physiology
Increase DBP
Improved oxygen delivery to coronaries
Decrease afterload
Reduced LV work
Complications
Insertion
Local structures
Aortic injury
arterial haemorrhage
Insitu
Thrombosis
Lower limb ischaemia
Gas embolus
Infection
Renal failure
Thrombocytopenia
Haemolysis
Pulmonary Artery Catheters
PAC-MAN trail
No difference in mortaility
No difference LOS
10% complication rate
Complications
Line acces
Bleeding
Air embolis
Vascular injury
Arterial puncture
Pnumothorax
Tamponade
Floating
Arrythmia
Tampondae
Valvular trauma
MIsplacement
Knotting
PAC in situ
Venous thromboembolism
Pulmonary infarction
Pulmonary arterial rupture
Mixed venous sats > Central venous sats Except:
Anaesthesia
TBI
Shock