What are the indications for ART line?
- End organ disease, rapid changes in BP, or monitored hypotension (Trauma, Cardiac, Vascular, Chest, Spine, Craniotomies, or for pt who will require monitored hypotension suggested by surgeon to reduce blood loss)
- Anticipated fluid shifts
- Long procedures
Where should you place the transducer in the ART line?
- •Supine- midaxillary
- •Sitting- circle of Willis
For an ART line, Raise a zeroed transducer 20cm from RA will lower the systolic and diastolic pressure reading by ___mmHg
For an ART line, 1 cm change in height= ___ mm Hg pressure difference
When interpreting the wave form of the ART line, what do the upstroke and the downstroke represent?
- Downstroke- PVR
In an ART line, Systolic pressure variation during the respiratory cycle > 8 mm correlates strongly with ________
What is underdampening of the ART line and what causes it?
- Underdampening- overestimate systolic pressure by 15 to 30 mm Hg and amplify catheter artifact
- Very small tubing (<1.5 mm diameter), long connection lines (>1.5 m), stiff tubing, or large catheters (18G)
What is overdampening and what causes it?
- Overdampening- underestimate systolic pressure
- High viscosity, soft tubing, air bubbles, blood clots, and kinked catheters
What are the complications of an ART line?
- Vascular insufficiency and vasospasm
- Blood loss
- Arterial thrombosis
- Air or thrombotic embolic
- Nerve damage
- Intra-arterial drug injection
Is the IJ located lateral or medial to the carotid artery?
- *Carotid puncture can occur on either side
TRANSDUCING THE SYSTEM DURING CANNULATION is done before or after dilation?
We place the CVL at the head of what to muscles?
The lateral and medial sternocleidomastoid muscles
What are the complications of a CVL?
- Thrombus formation
- Atrial/ventricular perforation
- Air embolism
- Vascular erosion
What are the relative contraindications to PA catheter?
- Presence of mechanical heart valve
- Wolf-parkinson-white syndrome
- Left bundle branch block (placement can induce RBBB)
- Hypercoagulable state
- Recent transvenous pacing wire placement