PAC Literature Summaries
Pulmonary Artery Catheter (PAC) Literature Summaries
Category CCC
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Pulmonary haemorrhage after PAOP measurement
OVERVIEW a life threatening time-critical emergency pulmonary artery rupture caused by inflation of the pulmonary artery catheter (PAC) balloon during ‘wedging’ (measurement of the pulmonary artery occlusion pressure) some experts advise against measuring PAWP because of the risk of pulmonary…
Troubleshooting PAC measurement
Troubleshooting Pulmonary Artery Catheter measurement
Mixed venous oxygen saturation (SvO2) monitoring
USES DESCRIPTION METHOD OF INSERTION AND/OR USE O2 flux = (cardiac output x (Hemoglobin concentration x SpO2 x 1.34) + (PaO2 x 0.003)) – oxygen consumption OTHER INFORMATION Usefulness Problems COMPLICATIONS INTERPRETATION High SvO2 Low SvO2 Causes of High SvO2…
Pulmonary Artery Wedge Pressure
PAOP or PAWP is pressure within the pulmonary arterial system when catheter tip ‘wedged’ in the tapering branch of one of the pulmonary arteries
in most patients this estimates LVEDP thus is an indicator of LVEDV (preload of the left ventricle)
Central venous oxygen saturation (ScvO2)
Central venous oxygen saturation (ScvO2) surrogate for SvO2 thus provides a surrogate measure of oxygen flux, reflecting the balance between oxygen delivery (DO2) and consumption (VO2).
Early Goal Directed Therapy in Septic Shock
EGDT: Within 6 hours of presentation to the Emergency Department intensive monitoring of specific circulatory parameters with the aggressive management of 5 key parameters to specified targets to optimise oxygen delivery to tissues.
SvO2 vs ScvO2
SvO2 vs ScvO2: used as a measure of the adequacy of total body O2 delivery; can be both displayed continuously
Hypoxaemia in Toxicology
AGENTS CLINICAL FEATURES INVESTIGATIONS SPECIFIC MANAGEMENT AND TRIGGERS FOR INTERVENTION Cyanide Carbon monoxide Methaemoglobinaemia References and Links
Liver Transplantation for Paracetamol Toxicity
Paracetamol overdose is the most common cause of fulminant hepatic failure in the USA (39% of cases). Paracetamol-induced hepatotoxicity is defined as a peak elevation in hepatic transaminases (ALT or AST) > 1000 IU/L in the context of paracetamol overdose
Fulminant Hepatic Failure
Fulminant Hepatic Failure = rapid onset of encephalopathy in conjunction with hepatic synthetic failure.
Local Anaesthetic Toxicity
Local Anaesthetic Toxicity-> sodium channel blockade -> arrhythmias and neurotoxicity