Obtrusive PRESSURE MONITORING .


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INVASIVE PRESSURE MONITORING. AIM Information concerning cardio respiratory performance and the effects of therapy in critically ill patients. 1. Arterial Blood Pressure Monitoring 2 . Central Venous Pressure Monitoring 3. Pulmonary Artery Pressure Monitoring
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Slide 1

Obtrusive PRESSURE MONITORING AIM Information concerning cardio respiratory execution and the impacts of treatment in basically sick patients

Slide 2

1. Blood vessel Blood Pressure Monitoring 2 . Focal Venous Pressure Monitoring 3. Aspiratory Artery Pressure Monitoring 4. Intra Cranial PressureMonitoring 5. Intra Abdominal Pressure Monitoring

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THINGS NEEDED 1. Weight TRANSDUCER 2. Arch 3. Weight TUBINGS(arterial expansion, 3 way stopcock, syringe) 4. Showing UNIT 5. TRANSDUCER STAND 6. Weight BAG WITH NORMAL SALINE 7. CATHETER SET

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Pressure transducer Air mineture tough and dispensable gadget These gadget can change over the development of the detecting diaphargm into an electrical flag

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Pressure tubings The catheter and stopcock are regularly connected to the flush gadget and transducer by non flexible weight tubing Continous flush gadget use to fill weight observing framework and keep from thickening into the catheter by continously flushing liquid through the framework at the rate of 1 to 3 ml/hr

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DISPLAY Pressure waveforms are envisioned on an aligned oscilloscope Digital presentations give a straightforward strategy to showing quantitative information from the weight waveform

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CALIBRATION The precision of circulatory strain estimation requires an exact reference point that is the patient mid axillary line Zeroing procedure is finished by shutting the patient side and opening the flip side of the three path to the climate Now squeeze zero

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ARTERIAL PRESSURE INDICATIONS Routine estimation of systemic pulse in icu Multiple blood gas investigation PREFERABLE SITES Radial,femoral,dorsalis pedis CANNULATION Collateral perfusion can be assessed by altered allens test

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CANNULE 20G INSYTE (spiral) Single lumen 18G seldinger method (femoral) COMPLICATIONS Infection Thrombosis Digital ischemia Vessel harm Bleeding, Nechrosis, Haemotoma

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CENTRAL VENOUS PRESSURE

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Indications 1.fliid organization 2.TPN hypertonic arrangements 3.vasoactive implantations 4.monitoring for right atrial pressure(CVP) PREPARABLE SITES 1.Internal jugular 2.subclavian 3.brachial 4.femoral

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COMPLICATIONS 1.At inclusion blood vessel puncture,pneumothorax,haemothorax 2.passage of wire/catheter arrhythmias,perforation of SVC,RA 3.Thrombosis 4.Catheter embolism

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PULMONARY ARTERY PRESSURE

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

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HAEMODYNAMIC MEASUREMENTS 1.CARDIAC OUTPUT a.injectate 10ml 5% dextrose @ room temp b.inject througout the resp cycle c.>3 estimations and disregard values>10% from normal 2.DERIVED VARIABLE a.CO/CI and SVR b.PVR(I), SV(I),LVSWI,RVSWI

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