Swann-Ganz catheter measurements

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  1. Pressure is first recorded in the superior vena cava with a pressure of 1-6 mm Hg and small oscillations
  2. When the catheter tip is advanced across the tricuspid valve and into the right ventricle, the pulsatile systolic pressure appears; normal right ventricle systolic pressure is 15-30 mm Hg
  3. When the catheter is carried across the pulmonic valve and into the pulmonary artery the diastolic pressure suddenly rises and the systolic pressure remains unchanged; normal pulmonary artery diastolic pressure is 6-12 mm Hg
  4. As the catheter is advanced along the pulmonary artery, the systolic component of the waveform suddenly disappears, the pressure that remains is the pulmonary capillary wedge pressure (PCWP) or pulmonary capillary opening pressure (PCOP) and is in the same range as the pulmonary artery diastolic pressure (6-12 mm Hg); when the wedge pressure tracing appears, deflate the balloon and the return of the pulmonary artery pressure should appear
    1. because there is no flow between the catheter tip and the left atrium, the PCWP should be the same as the left atrial pressure which is also equivalent to the left ventricular end-diastolic pressure
    2. PCWP > 20 mmHg occurs in left ventricular failure, pulmonary edema, mitral valve stenosis or regurgitation, aortic valve stenosis or regurgitation, pulmonary hypertension
  5. cardiac index = cardiac output/body surface area (normal 2.4-4.0 L/min/m2
  6. systemic vascular resistance (normal 1600-2400)
  7. central venous pressure (normal 1-6 mm Hg)
  8. saturation of venous blood is typically around 75% (body extracts about 25%)
  9. A meta-analysis of multiple randomized controlled trials testing the benefit of management based on Swann-Ganz catheter in critically ill patients, demonstrated that the use of pulmonary catheter, neither increased overall mortality or days in hospital nor conferred benefit.
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