Pulmonary Artery Catheters - How to Survive the ICU

Pulmonary Artery Catheters

General Comments:

As a medical student, you will not be responsible for manipulating the

Pulmonary Artery Catheter (PAC).

You should understand what values it measures and what they mean.

Think of the measurements as pertaining to Right or Left sides of the heart.

There is a finite amount of information for which you need to be responsible.

	Measured Values
CVP:	Central Venous Pressure	1-6 mm Hg
	Reflects Right Atrial Pressure
PAP:	Mean Pulmonary Artery Pressure
Systolic 15-30mm Hg
Diastolic 6-12mm Hg
PCWP:	Pulmonary Capillary Wedge Pressure	6 - 12mm Hg
	PCWP = Estimates left atrial heart pressure
	and left ventricular end diasolic pressure
CO:	Cardiac Output	3.5 - 7.5 L/min
MV02:	Mixed venous partial pressure of oxygen	70 - 75%
	Drawn from end of pulmonary artery catheter. Used to calculate how well oxygen is extracted by the tissue.

Derived Values
CI:	Cardiac Index	2.4 - 4.0 L/min/m2
	Calculated CO/ BSA
	BSA = (Ht cm x Wt kg) x 80 CI
SVI:	Stroke Volume Index	40 - 70 ml/beat/m2
	SVI = CI/ Hr
SVR:	Systemic Vascular Resistance	1600 - 2400 dynes.sec.m2/cm5
	SVR = MAP - RAP x 80 CI
PVR:	Pulmonary Vascular Resistance	200 - 400 dynes.see.m2/cm5
	PVR = PAP - PCWP x 80 CI

The Pulmonary
Artery Catheter

   Involves a Multilumen
  Catheter that is placed
  all the way into the
  Pulmonary Artery from
  the Subclavian Vein.

   Has a balloon tip that can
  be inflated & flow directed
  into the right heart & into
  the pulmonary vasculature.