Home-Amb-Card-Crit-Neuro-OB-Orth-Pain-Ped-Reg-Tran-Vasc-Misc
| HR | - | 50-100 |
| Cardiac Index | = CO / BSA | 2.8-4.2 |
| Cardiogenic Shock | ||
| CO | = HR x SV | 4.5-9.0 |
| CO | = VO2 / (CaO2-CvO2) | |
| CI | = CO / BSA | 2.5-4.0 |
| CVP | 2-10 | |
| Diastolic Art Pressure | 55-85 | |
| LVEDP | 12 (5-12 mmHg) | |
| MAP | = (SBP-DBP / 3) + DBP | 70-110 |
| Mitral Valve Parameters | ||
| Pulm Art Press Systolic | - | 15-30 |
| Pulm Art Press Diastolic | - | 5-12 |
| Pulm Art Press Mean | - | 11-18 |
| Pulm Art Resistance | 150-250 | |
| Pulm Vasc Resistance | = [(PAM-PCWP) x 80] /CO | 50-90 |
| PVRI | = [(PAM-PCWP) x 80] /CI | < 400 |
| Stroke Volume (SV) | = CO / HR | 60-120 |
| Stroke Index (SI) | = SV / BSA | 36-56 |
| Sys Art Pressure | - | 105-160 |
| SVR | =[ (MAP-CVP) x 80] / CO | 800-1200 |
| SVRI | =[ (MAP-CVP) x 80] / CI | 1600-3000 |
• Pulm. artery
pressure:
30/14 (10-25, 5-15 mm.
Hg)
• Mean pulm cap wedge press.:
12 (5-13 mm) approx. = to left
atrial pressure and LVEDP. Post MI best @ 14-18 mm. If exceeds @ 30 have
pulmonary edema. If mitral valve OK this reflects LVEDP, which in turn
reflects LVEDV and end diastolic fiber length (preload). For each mm of
PEEP > 25 the PCWP will be increased by 1 mm over the true LVEDP/LAP. With
low albumin CHF with lower PCWP.
• PAD: Pressure in pulm artery, measured with balloon down. In ideal cases may approx. PCWP, pulm HTN dissociates PAD/PCWP.
• CVP: 1-5 mm; reflects RVEDP/preload, approx. = RAP. If CVP > 15 no resp to incr fluid.
• Cardiac index: normal 2.5-3.6 L/min/m2. Typical CO is 4-6 L/min. Hypoperfusion at 1.8-2.2, shock at < 1.8.
• PVR: 800-1200
• Mitral valve
parameters:
• Norm 4.5-6.0 cm2
• < 2.5: incr.
atrial pressures
• < 1.5: over
25 mm LAP
• < 1.0: sx and
pulm edema
• Typical cardiogenic shock: CI @ 1.8, BP @ 90, incr. PVR, oliguria, pulm vasc cong on CXR. If PCWP is low or normal give fluids and maintain PCWP @ 15-20 mm.
• Venous Oxygen saturation and
A-V O2 gradient:
• This is a measure
of the balance between total body O2 supply and demand. Use with CO values.
• Mixed venous saturation:
normal 70-80%, heart failure < 60%, shock < 40%.[18 ml/dl]
• A-V O2 gradient:
normal 3.5-5.0. In cardiogenic shock the A-V gradient widens. In early
sepsis it narrows (incr. CO and microvascular shunting), in late sepsis
it widens.