1. INVASIVE PRESSURE MONITORING
AIM
Information concerning cardio
respiratory performance and the
effects of therapy in critically ill
patients

2. 1. Arterial Blood Pressure Monitoring
2 . Central Venous Pressure Monitoring
3. Pulmonary Artery Pressure Monitoring
4. Intra Cranial PressureMonitoring
5. Intra Abdominal Pressure Monitoring

3. THINGS NEEDED 1. PRESSURE TRANSDUCER 2. DOME
3. PRESSURE TUBINGS(arterial extension, 3 way stopcock, syringe)
4. DISPLAYING UNIT
5. TRANSDUCER STAND
6. PRESSURE BAG WITH NORMAL SALINE
7. CATHETER SET

5. Pressure transducer Air mineture rugged and disposable device
These device can convert the movement of the sensing diaphargm into an electrical signal

6. Pressure tubings
The catheter and stopcock are normally attached to the flush device and transducer by non elastic pressure tubing
Continous flush device-use to fill pressure monitoring system and prevent from clotting into the catheter by continously flushing fluid through the system at the rate of 1 to 3 ml/hr

7. DISPLAY Pressure waveforms are visualised on a calibrated oscilloscope
Digital displays provide a simple method for presenting quantitative data from the pressure waveform

8. CALIBRATION
The accuracy of blood pressure measurement requires an accurate reference point that is the patient mid axillary line
Zeroing process is done by closing the patient side and opening the other end of the three way to the atmosphere
Now press zero

10. ARTERIAL PRESSURE INDICATIONS
Routine measurement of systemic blood pressure in icu
Multiple blood gas analysis
PREFERABLE SITES
Radial,femoral,dorsalis pedis
CANNULATION
Collateral perfusion can be evaluated by modified allens test

11. CANNULE
20G INSYTE (radial)
Single lumen 18G seldinger technique (femoral)
COMPLICATIONS
Infection
Thrombosis
Digital ischemia
Vessel damage
Bleeding, Nechrosis, Haemotoma

13. CENTRAL VENOUS PRESSURE

14. Indications 1. fliid administration 2. TPN hypertonic solutions 3
Indications fliid administration TPN hypertonic solutions vasoactive infusions monitoring for right atrial pressure(CVP)
PREPARABLE SITES Internal jugular subclavian brachial femoral

15. COMPLICATIONS At insertion arterial puncture,pneumothorax,haemothorax passage of wire/catheter arrhythmias,perforation of SVC,RA Thrombosis Catheter embolism

17. PULMONARY ARTERY PRESSURE

18. INDICATION
Haemodynamic measurement(cardiac output, stroke volume, systemic vascular resistance)
Measurement of right heart pressure(RAP,PAP)
Acute pulmonary hypertension
Pulmonary embolism
Cardiac tamponade
Estimation or preload/left heart filling(PAOP)
Derivation of oxygen variables(VO2,DO2)

19. HAEMODYNAMIC MEASUREMENTS 1. CARDIAC OUTPUT a
HAEMODYNAMIC MEASUREMENTS CARDIAC OUTPUT a.injectate 10ml 5% room temp b.inject througout the resp cycle c.>3 measurements and ignore values>10% from average DERIVED VARIABLE a.CO/CI and SVR b.PVR(I), SV(I),LVSWI,RVSWI