RT Book, Section
A1 Butterworth, John F.
A1 Mackey, David C.
A1 Wasnick, John D.
SR Print(0)
ID 57230594
T1 Chapter 5. Cardiovascular Monitoring
T2 Morgan & Mikhail's Clinical Anesthesiology, 5e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-162703-0
LK accessanesthesiology.mhmedical.com/content.aspx?aid=57230594
RD 2021/09/20
AB The  central  venous  pressure  catheter’s  tip  should  not  be  allowed  to  migrate  into  the  heart  chambers.  Although  the  pulmonary  artery  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  measurements  and  pulse  contour  analyses  of  the  arterial  pressure  waveform.  Relative  contraindications  to  pulmonary  artery  catheterization  include  left  bundle-branch  block  (because  of  the  concern  about  complete  heart  block)  and  conditions  associated  with  greatly  increased  risk  of  arrhythmias,  such  as  Wolff-Parkinson-White  syndrome.  Pulmonary  artery  pressure  should  be  continuously  monitored  to  detect  an  overwedged  position  indicative  of  catheter  migration.  Accurate  measurements  of  cardiac  output  depend  on  rapid  and  smooth  injection,  precisely  known  injectant  temperature  and  volume,  correct  entry  of  the  calibration  factors  for  the  specific  type  of  pulmonary  artery  catheter  into  the  cardiac  output  computer,  and  avoidance  of  measurements  during  electrocautery.