ISBN-10:
0721692931
ISBN-13:
2900721692936
Pub. Date:
04/03/2002
Publisher:
Elsevier Health Sciences
Hemodynamic Monitoring: Invasive and Noninvasive Clinical Application / Edition 3

Hemodynamic Monitoring: Invasive and Noninvasive Clinical Application / Edition 3

by Gloria Oblouk Darovic

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Product Details

ISBN-13: 2900721692936
Publisher: Elsevier Health Sciences
Publication date: 04/03/2002
Edition description: REV
Pages: 720
Product dimensions: 8.02(w) x 9.96(h) x 1.33(d)

Table of Contents

Unit 1Anatomy, Physiology, and Assessment Techniques1
1Introduction to the Care of Critically III and Injured Patients3
Clinical Limitations of Hemodynamic Measurements3
Other Important Considerations5
2Pulmonary Anatomy and Physiology9
Pulmonary Anatomy and Physiology10
Ventilation10
Distribution15
Diffusion19
Perfusion/Transport23
Physical Factors that Affect Distribution of Lung Blood Volume28
Transport35
3Physical Assessment of the Pulmonary System43
Overview of Physical Assessment43
Symptoms and Signs of Pulmonary Disease44
Specific Techniques of Physical Assessment51
4Cardiovascular Anatomy and Physiology57
Overview of the Cardiovascular System57
Heart57
Factors Affecting Cardiac Output73
Coronary Circulation74
Factors That Determine Coronary Blood Flow75
Circuit (Vascular System)79
5Physical Assessment of the Cardiovascular System91
Symptoms and Signs of Cardiovascular Disease91
Specific Techniques of Physical Assessment94
Unit 2Monitoring Techniques111
6Fluid-Filled Monitoring Systems113
Fluid-Filled Monitoring Systems113
Types of Monitoring Systems113
Components of the Fluid-Filled Electronic Monitoring System115
Physical Principles Involved in Pressure Monitoring Systems117
Dynamic Response Testing121
Orientation of the Intravascular Catheter Relative to the Flow of Blood and Catheter Whip Artifact123
Assembly of the Monitoring System123
Patient Position for Zero Referencing and Pressure Monitoring124
Zero Referencing125
Leveling125
Monitor and Transducer Calibration129
Conclusion129
Glossary130
7Arterial Pressure Monitoring133
Definition of Arterial Pressure133
Clinical Caveats for All Types of Arterial Pressure Measurements134
Indirect Methods of Measuring Blood Pressure135
Direct Arterial Pressure Measurement142
Comparison of Direct and Indirect Blood Pressure Measurements158
8Establishment of Central Venous Access161
Insertion Sites162
Equipment for Cannulation of the Central Veins164
Preinsertion Protocol and Considerations164
Techniques for Gaining Venous Access166
Percutaneous Access Systems and Techniques167
Sites of Central Venous Catheter Insertion169
Immediate Life-Threatening Complications173
Postinsertion Protocol and Site Maintenance174
Central Venous Catheter Removal174
9Monitoring Central Venous Pressure177
Clinical Application of Central Venous Pressure Measurements177
Limitations of Central Venous Pressure Monitoring180
Central Venous Pressure Measurements Obtained by a Pressure Transducer Versus a Calibrated Water Manometer181
Central Venous Insertion Sites and Protocol for Catheter Insertion182
Types of Catheters Used for Central Venous Pressure Measurement182
Protocols for Obtaining Central Venous Pressure Measurements Using a Pressure Tranducer/Electronic Monitor183
Complications of Central Venous Pressure Monitoring185
Catheter Removal189
10Pulmonary Artery Pressure Monitoring191
Indications for Pulmonary Artery Catheterization192
Contraindications and Special Considerations of Pulmonary Artery Catheterization192
Effects of Pulmonary Artery Catheterization on Patient Outcome193
Catheter Design and Types195
Methods and Sites of Pulmonary Artery Catheter Insertion199
Preparation and Equipment Setup199
Removal of the Pulmonary Artery Catheter213
Clinical Application of the Pulmonary Artery Catheter213
Potential Problems and Pitfalls in Obtaining Accurate Hemodynamic Measurements222
Identification and Solution of Monitoring Problems234
Complications of Pulmonary Artery Catheterization236
11Monitoring Cardiac Output245
Factors Affecting Cardiac Output245
Effect of Anatomic Shunting and Regurgitant Flow on Cardiac Output Measurements246
Clinical Application of Cardiac Output Measurements248
Invasive Methods of Calculating Cardiac Output248
Noninvasive Means of Calculating Cardiac Output259
12Monitoring Oxygenation263
Physiologic Effects of Hypoxia264
Oxygen Supply, Demand, and Consumption Balance264
Conditions That May Compromise Tissue Oxygenation267
Compensatory Mechanisms268
Monitoring Techniques for Continuously Assessing the Effectiveness of the Oxygen Transport and Utilization Systems269
Clinical Applications and Considerations of Combined Arterial and Mixed Venous Oxygen Saturation Monitoring274
Conditions Associated with Increases In Svo[subscript 2]278
Summary280
Unit 3Care of Critically Ill and Injured Patients283
13Infusion-Related Sepsis285
Incidence286
Standardized Microbiologic Definitions of Intravascular Device-Related Infections286
Clinical Syndromes of Infusion-Related Infection287
Pathogenesis of Infusion-Related Sepsis288
Diagnosis of Infusion-Related Sepsis290
Microorganisms Associated with Infusion-Related Sepsis292
Risk Factors for Infusion-Related Sepsis293
Septic Risk Specific to Types of Vascular Catheters295
Treatment297
Prevention and Management297
14Pharmacologic Influences on Hemodynamic Parameters305
Role of Hemodynamic Monitoring in Intensive Care Unit Drug Therapy305
Factors That Determine Drug Absorption, Distribution, Metabolism, and Excretion306
Mechanisms of Action of Cardiovascular Medications308
Pharmacologic Modification of Autonomic Nervous System Influences on the Cardiovascular System309
Antiarrhythmic Drug Therapy311
Intravenous Medications Commonly Used for Hemodynamic Support of Critically Ill or Injured Patients315
Discussion344
15Intraaortic Balloon Counterpulsation347
Definition347
Principles Underlying Balloon Counterpulsations347
Technique of Catheter Placement349
Effects of the Intraaortic Balloon Pump on the Arterial Waveform349
Triggers for Balloon Inflation and Deflation350
Timing of Inflation/Deflation Cycles350
Physical Assessment Considerations for Patients Being Maintained on the Intraaortic Balloon Pump354
Balloon Pressure Waveform355
Causes of Abnormal Balloon Pressure Waveform Morphology356
Types and Causes of Abnormal Balloon Pressure Waveforms356
Complications and Risk Factors357
Conclusion357
16Monitoring the Patient in Shock361
Pathophysiology361
Stages of Shock366
Diagnosis of Shock370
General Principles of Therapy372
Classification of Shock by Cause376
Other Categories of Shock397
17Monitoring the Patient with Multiple-System Organ Dysfunction403
Historical Perspective403
Definition404
Epidemiology404
Diagnostic Criteria for Organ System Dysfunction and Failure404
Pathophysiology404
Hemodynamic Profile409
Clinical Presentation and Course412
Laboratory Examination413
Management415
Prognosis418
18Monitoring Patients with Acute Pulmonary Disease421
Acute Respiratory Failure422
Causes of Acute Respiratory Failure427
Summary467
19Pediatric Evaluation and Monitoring Considerations471
Cardiopulmonary Physiology and Maturation in Cardiovascular Function471
Clinically Relevant Differences Between Children and Adults479
Clinical Assessment of Hemodynamic Competency in Pediatric Patients480
Congenital Heart Disease485
Fluid-Filled Monitoring Systems494
Monitoring System Setup to Ensure Accurate Display of Hemodynamic Measurements496
Application of Hemodynamic Monitoring Systems in Assessment of Pediatric Patients499
Noninvasive and Invasive Techniques of Blood Pressure Measurement499
Conclusions511
20Specific Monitoring Considerations for Patients with Cardiac Disease515
Factors Affecting Cardiac Function and Stroke Colume515
Heart Failure522
Conclusion526
21Ischemic Heart Disease527
Epidemiology and Causes527
Pathophysiology527
Angina Pectoris531
Acute Myocardial Infarction540
22Valvular Heart Disease561
Aortic Stenosis561
Aortic Regurgitation (Insufficiency)569
Mitral Stenosis574
Mitral Regurgitation (Insufficiency)584
Tricuspid Regurgitation (Insufficiency)592
Complex Valvular Heart Disease597
23Cardiomyopathies and Pericardial Disease601
Cardiomyopathies601
Constrictive Pericardial Disease (Constrictive Pericarditis)624
Pericardial Tamponade (Cardiac Tamponade)627
24Monitoring the Patient Following Open Heart Surgery637
Historical Perspective637
Preoperative Evaluation638
Preoperative Preparation of the Patient and Family640
Postoperative Management640
Index659

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