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Hemodynamic Monitoring & Assessment Flashcards

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  1. The thermodilution method of measuring cardiac output involves injecting cold saline into which port of the pulmonary artery catheter?

    Answer: Proximal (RA) port

    Cold saline is injected into the proximal (right atrial) port, and the temperature change is detected by the thermistor at the catheter tip to calculate cardiac output via the Stewart-Hamilton equation.

  2. Which hemodynamic parameter primarily reflects left ventricular preload?

    Answer: Pulmonary capillary wedge pressure (PCWP)

    PCWP approximates left atrial pressure and left ventricular end-diastolic pressure, making it the best invasive surrogate for left ventricular preload.

  3. Pulse pressure variation (PPV) >13% during mechanical ventilation suggests:

    Answer: Fluid responsiveness

    PPV >13% in mechanically ventilated patients with sinus rhythm indicates significant preload dependence and predicts that the patient will respond to fluid administration with increased cardiac output.

  4. In a patient with acute right ventricular infarction, the expected hemodynamic profile includes:

    Answer: Low PCWP, low CO, high CVP

    RV infarction causes high CVP (RV failure/backup) with low PCWP (underfilling of LV) and reduced CO, distinguishing it from left-sided failure.

  5. Which hemodynamic value is used to calculate pulmonary vascular resistance (PVR)?

    Answer: (mPAP – PCWP) / CO

    PVR = (mean PAP – PCWP) / CO × 80, reflecting the resistance across the pulmonary vascular bed from pulmonary artery to left atrium.

  6. Continuous SvO₂ monitoring via fiberoptic pulmonary artery catheter is particularly useful for detecting:

    Answer: Imbalances between oxygen delivery and consumption

    Continuous SvO₂ reflects the balance between oxygen delivery (DO₂) and oxygen consumption (VO₂); a falling SvO₂ signals inadequate delivery or increased demand before hemodynamic deterioration is clinically apparent.

  7. Frank-Starling law states that increased ventricular preload leads to:

    Answer: Increased stroke volume up to an optimal point

    The Frank-Starling mechanism describes that increased end-diastolic volume (preload) increases myofilament stretch and cross-bridge formation, augmenting stroke volume up to an optimal filling pressure.