Monitoring
. .
Email:
thananchairama@hotmail.com
CVP Monitoring
1. CVP ?
1.1
1.2
1.3
1.4
1.5
1.6
Blood volume
Right ventricular venous return
RV preload
RV pump function
LV preload
Risk of pulmonary edema
2. CVP ?
3. CVP ?
4. CVP ?
CVP Monitoring
5. CVP ?
6. CVP ?
CVP ?
IV fluid keep CVP 8-12 cm H2O ?
7. central veous line ?
8. Central line
peripheral line ?
9. central line ? ?
10. CVP ?
11. CVP ?
CVP Monitoring
12. ?
CVP ?
13. 0 (zero level)
?
14. CVP ?
15. CVP ?
16. ?
17. ?
18. monitor CVP ?
= CVP RVDP
CVP VR
CVP VR
CVP VR
CVP as RV Preload
SWI,
SV
fiber length
RVEDV
RVEDP
RAP
CVP
-- RV compliance
-- Tricuspid valve function, ITP
-- Catheter tip location, technical errors
PAOP as LV Preload
SWI,
SV
LVEDV
LVEDP
LAP
PVP
PAOP
PADP
-- LV compliance
-- Mitral valve function, ITP
CVP
Optimal Preload
PCWP
CVP
Acute MI
15
15
mm Hg
cm H2O
PAOP 20-22 mm Hg
>22 mm Hg
>20-25 cm H2O
Rt-Lt discrepancy
CVP
point of
min. capacitance
point of
max. capacitance
CVP
0 mm Hg
-5 to 15 mm Hg
5-12 cm H2O
-5 to 15-20 cm H2O can be normal
- catheter tip location
- individuals compensated normal
systole
diastole
volume loading
CVP PAOP loading
equilibration of venous pressure
volume rate volume therapy
CVP PAOP
<8
<12
8-15
12-16
>15 cm H2O
>16 mm Hg
50 mL/10 min
>5
>7
3-5
4-7
<2
<3
3-5
4-7
<2
<3
2. CVP waveform
3. Chest X-ray: carina,
head of clavicle, medial 1/3 clavicle
(
)
1. PPV CVP
absolute value
2.
- ITP
- ITP
3.
4.
?
end-expiration
cycle
CVP Monitoring
1. CVP ?
1.1
1.2
1.3
1.4
1.5
1.6
Blood volume
Right ventricular venous return
RV preload
RV pump function
LV preload
Risk of pulmonary edema
2. CVP ?
3. CVP ?
4. CVP ?
CVP Monitoring
5. CVP ?
6. CVP ?
CVP ?
IV fluid keep CVP 8-12 cm H2O ?
7. central veous line ?
8. Central line
peripheral line ?
9. central line ? ?
10. CVP ?
11. CVP ?
CVP Monitoring
12. ?
CVP ?
13. 0 (zero level)
?
14. CVP ?
15. CVP ?
16. ?
17. ?
18. monitor CVP ?