Page 25 - Critical Care Notes

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Pulmonary Artery Catheter
The purpose of the pulmonary artery catheter, also known as the Swan-Ganz
catheter, is to assess and monitor left ventricular function and can determine
preload, assess contractility, and approximate afterload.
PCWP approximates left atrial pressure and left ventricular end-diastolic pressure.
Increases in PCWP, LAP, or LVEDP indicate heart failure, hypervolemia, shock,
mitral valve insufficiency, or stenosis. Decreases in PCWP, LAP, or LVEDP indi-
cate hypovolemia.
PA Catheter Waveforms
The pulmonary artery catheter is threaded through the right atrium and right
ventricle and into the pulmonary artery. Insertion is done via fluoroscopy or
monitoring waveform changes.
Catheter advanced to
right atrium, balloon
is inflated. Pressure 40
is low, usually
mm Hg 30 Balloon
2–5 mm Hg.
20
10 catheter
Right
0 atrium
Time
Catheter is floated to
right ventricle with
the balloon inflated. 40
Waveforms indicate
a systolic pressure mm Hg 30
of 25–30 mm Hg and 20
Balloon
a diastolic pressure 10
of 0–5 mm Hg. catheter
0
Right Time
ventricle
Continued

BASICS