Pulmonary Artery Catheterization

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Pulmonary Artery Catheterization

• RSPT 2355

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Why use the Pulmonary Artery Catheter?

• Gives Diagnostic information on critically ill
  patients
• Helps diagnose the cause of hypotension
• Helps in fluid status maintenance
• Give critical cardiac function data

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Equipment

• Swan-Ganz pulmonary artery catheter
• 2 Transducer set-ups
• CVP
• PA
• Cardiac monitor
• Multiple waveforms
• Cardiac output capabilities

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Also known as a Right Heart Catheter. The
position from distal end to proximal end is
Pulmonary Artery, Right ventricle, right atrium,
vena cava, subclavian vein.
Subclavian
Tip in PulmonaryArtery
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• Parts
• Balloon
• Openings
• Distal (tip)
• Proximal
• Injectate
• Thermister probe
• Ports
• Balloon
• Distal Port
• Proximal port
• Injectate
• Electronics connection
• Oximeter

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Information given by the Swan

• Pulmonary Artery (PA) Pressure
• Central Venous Pressure (CVP) Pressure
• Pulmonary Capillary Wedge Pressure (PCWP or
  Wedge)
• Cardiac Output (in Liters/minute)
• SVO2
• Systemic Vascular Resistance
• Pulmonary Vascular Resistance
• Cardiac Index

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Information given by the Swan

• This data can be subdivided into the following
  areas
• Continuously Monitored
• Intermittently Monitored
• Derived by calculations

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Information given by the Swan

• Continuously Monitored Parameters
• Pulmonary Artery Pressure (PA)
• Central Venous Pressure (CVP)
• SvO2

Measurements recorded in mmHg These values are
a measurement of the fluid pressure in the
Pulmonary Artery, and Vena Cava respectively.
These values are useful in quantifying and
diagnosing cardiopulmonary disease.
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Monitor showing continuously monitored PA and CVP
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Also continuously monitored.

• Although optional

SvO2
Saturation of Venous Oxygen Measured in the
Pulmonary Artery This reading is the Only TRUE
mixed venous.
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Intermittently monitored

• Pulmonary Capillary Wedge pressure (PCWP)
• Balloon is inflated, a pressure reading is taken,
  the balloon is deflated. Leaving the balloon
  inflated with INFARCT the lung!

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Intermittently monitored, cont.

• Cardiac output by Thermo dilution
• Cold fluid is injected into the Injectate port
  of the catheter. The temperature of the fluid is
  measured at two points by the thermistor on the
  catheter and calculated to cardiac output.

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Calculations

• Systemic Vascular Resistance
• How hard is it get blood through the vascular
  system?
• Pulmonary Vascular Resistance
• How hard does the right heart have to work to get
  blood through the lungs and back to the left
  heart?
• Cardiac Index

Careful! These calculations are subject to error!
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The Measured Values
5 mmHg

• CVP Low pressure reading -
• PA Systolic/diastolic-
• SvO2 75

20/10
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The intermittent values

• PCWP
• Cardiac Output normally

8 mmHg
6 l/m