Chapter 46 Cardiovascular Monitoring and Management of the Patient in the Intensive Care Unit

Objectives Describe the cardiovascular monitoring techniques used in the care of critically ill patients and how to interpret the results of hemodynamic monitoring.

Cardiac and Cardiovascular Monitoring Arterial blood pressure Invasive or noninvasive Central venous pressure (CVP) Pulmonary arterial catheter: high risk-to-return ratio, so only used on most complicated patients Allows monitoring of Cardiac output/cardiac index Pulmonary arterial pressure Pulmonary capillary wedge pressure Pulmonary vascular resistance Systemic vascular resistance

Hemodynamic Monitoring Complete hemodynamic profile from PA catheter eases determination of cause for altered hemodynamic status. Table 46-4 shows expected changes in hemodynamic values associated with clinical presentation of cardiac or cardiovascular dysfunction.