FFICM FFICM Critical Care Monitoring and Hemodynamics 1 — Questions and Answers
Question 1: Which parameter is measured by a pulmonary artery catheter to assess left heart preload?
- Pulmonary artery wedge pressure (Correct answer)
- Central venous pressure
- Pulmonary artery systolic pressure
- Cardiac output
Correct answer: Pulmonary artery wedge pressure
Pulmonary artery wedge pressure (PAWP) reflects left atrial pressure and is used as a surrogate for left ventricular end-diastolic pressure.
Question 2: What is the normal range for cardiac index in a healthy adult at rest?
- 2.2–4.0 L/min/m² (Correct answer)
- 1.0–2.0 L/min/m²
- 4.5–6.0 L/min/m²
- 0.5–1.5 L/min/m²
Correct answer: 2.2–4.0 L/min/m²
Cardiac index (CI) is cardiac output normalized to body surface area, with a normal range of 2.2–4.0 L/min/m² in adults.
Question 3: In the ICU, which arterial waveform finding suggests hypovolemia during positive pressure ventilation?
- Pulse pressure variation >13% (Correct answer)
- Wide pulse pressure
- Dicrotic notch elevation
- Reduced diastolic runoff
Correct answer: Pulse pressure variation >13%
Pulse pressure variation (PPV) >13% during mechanical ventilation is a reliable dynamic indicator of fluid responsiveness indicating hypovolemia.
Question 4: Which mixed venous oxygen saturation (SvO2) value indicates adequate global oxygen delivery in a critically ill patient?
- ≥65% (Correct answer)
- ≤40%
- ≥90%
- 50–55%
Correct answer: ≥65%
An SvO2 ≥65% generally indicates adequate global oxygen delivery relative to consumption; values below this suggest oxygen debt.
Question 5: What does the Stewart-Hamilton equation calculate when using thermodilution?
- Cardiac output (Correct answer)
- Systemic vascular resistance
- Stroke volume variation
- Pulmonary vascular resistance
Correct answer: Cardiac output
The Stewart-Hamilton equation calculates cardiac output by analyzing the temperature change over time following cold saline injection into the pulmonary artery catheter.
Question 6: In critically ill patients, which hemodynamic profile is characteristic of septic shock?
- High CO, low SVR, low MAP (Correct answer)
- Low CO, high SVR, high MAP
- High CO, high SVR, high MAP
- Low CO, low SVR, high MAP
Correct answer: High CO, low SVR, low MAP
Septic shock classically presents with a hyperdynamic state: high cardiac output and low systemic vascular resistance leading to low mean arterial pressure.
FFICM FFICM Critical Care Monitoring and Hemodynamics 1
Which parameter is measured by a pulmonary artery catheter to assess left heart preload?