TY - CHAP M1 - Book, Section TI - Cardiovascular Monitoring A1 - Butterworth IV, John F. A1 - Mackey, David C. A1 - Wasnick, John D. PY - 2022 T2 - Morgan & Mikhail’s Clinical Anesthesiology, 7e AB - KEY CONCEPTS The tip of the central venous pressure catheter should not be allowed to migrate into the heart chambers. Although the pulmonary artery (PA) catheter can be used to guide goal-directed hemodynamic therapy to ensure organ perfusion in shock states, other less invasive methods to determine hemodynamic performance are available, including transpulmonary thermodilution cardiac output (CO) measurements, pulse contour analyses of the arterial pressure waveform, and methods based on bioimpedance measurements across the chest. Relative contraindications to PA catheterization include left bundle-branch block (because of the concern about complete heart block) and conditions associated with a greatly increased risk of arrhythmias. Pulmonary artery pressure should be continuously monitored to detect an overwedged position indicative of catheter migration. Accurate measurements of CO depend on rapid and smooth injection, precisely known injectant temperature and volume, correct entry of the calibration factors for the specific type of PA catheter into the CO computer, and avoidance of measurements during electrocautery. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/12 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1206709062 ER -