Hemodynamic monitoring : invasive and noninvasive clinical application / Gloria Oblouk Darovic.

Format:

Book

Author/Creator:

Darovic, Gloria Oblouk.

Language:

English

Subjects (All):

Hemodynamic monitoring.

Cardiovascular system--Diseases--Diagnosis.

Cardiovascular system.

Hemodynamics.

Cardiovascular Diseases--physiopathology.

Monitoring, Physiologic--methods.

Medical Subjects:

Hemodynamics.

Cardiovascular Diseases--physiopathology.

Monitoring, Physiologic--methods.

Physical Description:

xxii, 676 pages : illustrations ; 26 cm

Edition:

Third edition.

Place of Publication:

Philadelphia : W.B. Saunders Co., [2002]

Summary:

Praised by nursing students for its straightforward language and readability, this interdisciplinary reference on bedside hemodynamic monitoring covers the technical aspects of clinical monitoring, including diagnostic and management principles for fluid-filled systems, intracranial hemodynamics, open-heart surgery patients, pediatric patients, and more! Well illustrated chapters detail exactly how to insert and manipulate catheters safely, read monitors properly, and interpret readings accurately. Precise illustrations deliver crucial details on delicate techniques. Content on the strengths and shortcomings of various hemodynamic monitoring modalities has been expanded significantly in the third editon, and a new chapter on intra-aortic balloon pumping has been added.TOC.

Contents:

Unit 1 Anatomy, Physiology, and Assessment Techniques 1

1 Introduction to the Care of Critically III and Injured Patients / Gloria Oblouk Darovic, Karen L. Stratton 3

Clinical Limitations of Hemodynamic Measurements 3

Other Important Considerations 5

2 Pulmonary Anatomy and Physiology / Gloria Oblouk Darovic, Joseph P. Zbilut 9

Pulmonary Anatomy and Physiology 10

Ventilation 10

Distribution 15

Diffusion 19

Perfusion/Transport 23

Physical Factors that Affect Distribution of Lung Blood Volume 28

Transport 35

3 Physical Assessment of the Pulmonary System / Gloria Oblouk Darovic 43

Overview of Physical Assessment 43

Symptoms and Signs of Pulmonary Disease 44

Specific Techniques of Physical Assessment 51

4 Cardiovascular Anatomy and Physiology / Gloria Oblouk Darovic 57

Overview of the Cardiovascular System 57

Heart 57

Factors Affecting Cardiac Output 73

Coronary Circulation 74

Factors That Determine Coronary Blood Flow 75

Circuit (Vascular System) 79

5 Physical Assessment of the Cardiovascular System / Gloria Oblouk Darovic 91

Symptoms and Signs of Cardiovascular Disease 91

Specific Techniques of Physical Assessment 94

Unit 2 Monitoring Techniques 111

6 Fluid-Filled Monitoring Systems / Gloria Oblouk Darovic, Joseph P. Zbilut 113

Fluid-Filled Monitoring Systems 113

Types of Monitoring Systems 113

Components of the Fluid-Filled Electronic Monitoring System 115

Physical Principles Involved in Pressure Monitoring Systems 117

Dynamic Response Testing 121

Orientation of the Intravascular Catheter Relative to the Flow of Blood and Catheter Whip Artifact 123

Assembly of the Monitoring System 123

Patient Position for Zero Referencing and Pressure Monitoring 124

Zero Referencing 125

Leveling 125

Monitor and Transducer Calibration 129

7 Arterial Pressure Monitoring / Gloria Oblouk Darovic 133

Definition of Arterial Pressure 133

Clinical Caveats for All Types of Arterial Pressure Measurements 134

Indirect Methods of Measuring Blood Pressure 135

Direct Arterial Pressure Measurement 142

Comparison of Direct and Indirect Blood Pressure Measurements 158

8 Establishment of Central Venous Access / Anand Kumar, Gloria Oblouk Darovic 161

Insertion Sites 162

Equipment for Cannulation of the Central Veins 164

Preinsertion Protocol and Considerations 164

Techniques for Gaining Venous Access 166

Percutaneous Access Systems and Techniques 167

Sites of Central Venous Catheter Insertion 169

Immediate Life-Threatening Complications 173

Postinsertion Protocol and Site Maintenance 174

Central Venous Catheter Removal 174

9 Monitoring Central Venous Pressure / Gloria Oblouk Darovic, Anand Kumar 177

Clinical Application of Central Venous Pressure Measurements 177

Limitations of Central Venous Pressure Monitoring 180

Central Venous Pressure Measurements Obtained by a Pressure Transducer Versus a Calibrated Water Manometer 181

Central Venous Insertion Sites and Protocol for Catheter Insertion 182

Types of Catheters Used for Central Venous Pressure Measurement 182

Protocols for Obtaining Central Venous Pressure Measurements Using a Pressure Tranducer/Electronic Monitor 183

Complications of Central Venous Pressure Monitoring 185

Catheter Removal 189

10 Pulmonary Artery Pressure Monitoring / Gloria Oblouk Darovic 191

Indications for Pulmonary Artery Catheterization 192

Contraindications and Special Considerations of Pulmonary Artery Catheterization 192

Effects of Pulmonary Artery Catheterization on Patient Outcome 193

Catheter Design and Types 195

Methods and Sites of Pulmonary Artery Catheter Insertion 199

Preparation and Equipment Setup 199

Removal of the Pulmonary Artery Catheter 213

Clinical Application of the Pulmonary Artery Catheter 213

Potential Problems and Pitfalls in Obtaining Accurate Hemodynamic Measurements 222

Identification and Solution of Monitoring Problems 234

Complications of Pulmonary Artery Catheterization 236

11 Monitoring Cardiac Output / Gloria Oblouk Darovic, Patricia G. Graham, Mary Ann F. Pranulis 245

Factors Affecting Cardiac Output 245

Effect of Anatomic Shunting and Regurgitant Flow on Cardiac Output Measurements 246

Clinical Application of Cardiac Output Measurements 248

Invasive Methods of Calculating Cardiac Output 248

Noninvasive Means of Calculating Cardiac Output 259

12 Monitoring Oxygenation / Gloria Oblouk Darovic 263

Physiologic Effects of Hypoxia 264

Oxygen Supply, Demand, and Consumption Balance 264

Conditions That May Compromise Tissue Oxygenation 267

Compensatory Mechanisms 268

Monitoring Techniques for Continuously Assessing the Effectiveness of the Oxygen Transport and Utilization Systems 269

Clinical Applications and Considerations of Combined Arterial and Mixed Venous Oxygen Saturation Monitoring 274

Conditions Associated with Increases In Svo[subscript 2] 278

Unit 3 Care of Critically Ill and Injured Patients 283

13 Infusion-Related Sepsis / Anand Kumar, Elizabeth Krzywda, Gloria Oblouk Darovic 285

Incidence 286

Standardized Microbiologic Definitions of Intravascular Device-Related Infections 286

Clinical Syndromes of Infusion-Related Infection 287

Pathogenesis of Infusion-Related Sepsis 288

Diagnosis of Infusion-Related Sepsis 290

Microorganisms Associated with Infusion-Related Sepsis 292

Risk Factors for Infusion-Related Sepsis 293

Septic Risk Specific to Types of Vascular Catheters 295

Treatment 297

Prevention and Management 297

14 Pharmacologic Influences on Hemodynamic Parameters / Gloria Oblouk Darovic, Robert Simonelli 305

Role of Hemodynamic Monitoring in Intensive Care Unit Drug Therapy 305

Factors That Determine Drug Absorption, Distribution, Metabolism, and Excretion 306

Mechanisms of Action of Cardiovascular Medications 308

Pharmacologic Modification of Autonomic Nervous System Influences on the Cardiovascular System 309

Antiarrhythmic Drug Therapy 311

Intravenous Medications Commonly Used for Hemodynamic Support of Critically Ill or Injured Patients 315

15 Intraaortic Balloon Counterpulsation / Gloria Oblouk Darovic 347

Principles Underlying Balloon Counterpulsations 347

Technique of Catheter Placement 349

Effects of the Intraaortic Balloon Pump on the Arterial Waveform 349

Triggers for Balloon Inflation and Deflation 350

Timing of Inflation/Deflation Cycles 350

Physical Assessment Considerations for Patients Being Maintained on the Intraaortic Balloon Pump 354

Balloon Pressure Waveform 355

Causes of Abnormal Balloon Pressure Waveform Morphology 356

Types and Causes of Abnormal Balloon Pressure Waveforms 356

Complications and Risk Factors 357

16 Monitoring the Patient in Shock / Cory M. Franklin, Gloria Oblouk Darovic 361

Pathophysiology 361

Stages of Shock 366

Diagnosis of Shock 370

General Principles of Therapy 372

Classification of Shock by Cause 376

Other Categories of Shock 397

17 Monitoring the Patient with Multiple-System Organ Dysfunction / Barry A.

Mizock, Gloria Oblouk Darovic 403

Historical Perspective 403

Epidemiology 404

Diagnostic Criteria for Organ System Dysfunction and Failure 404

Pathophysiology 404

Hemodynamic Profile 409

Clinical Presentation and Course 412

Laboratory Examination 413

Management 415

Prognosis 418

18 Monitoring Patients with Acute Pulmonary Disease / Gloria Oblouk Darovic 421

Acute Respiratory Failure 422

Causes of Acute Respiratory Failure 427

19 Pediatric Evaluation and Monitoring Considerations / Mary Fran Hazinski 471

Cardiopulmonary Physiology and Maturation in Cardiovascular Function 471

Clinically Relevant Differences Between Children and Adults 479

Clinical Assessment of Hemodynamic Competency in Pediatric Patients 480

Congenital Heart Disease 485

Fluid-Filled Monitoring Systems 494

Monitoring System Setup to Ensure Accurate Display of Hemodynamic Measurements 496

Application of Hemodynamic Monitoring Systems in Assessment of Pediatric Patients 499

Noninvasive and Invasive Techniques of Blood Pressure Measurement 499

20 Specific Monitoring Considerations for Patients with Cardiac Disease / Robert J. Henning, Gloria Oblouk Darovic 515

Factors Affecting Cardiac Function and Stroke Colume 515

Heart Failure 522

21 Ischemic Heart Disease / Robert J. Henning, Gloria Oblouk Darovic 527

Epidemiology and Causes 527

Pathophysiology 527

Angina Pectoris 531

Acute Myocardial Infarction 540

22 Valvular Heart Disease / Gregory L. Freeman, Lloyd W. Klein, Gloria Oblouk Darovic 561

Aortic Stenosis 561

Aortic Regurgitation (Insufficiency) 569

Mitral Stenosis 574

Mitral Regurgitation (Insufficiency) 584

Tricuspid Regurgitation (Insufficiency) 592

Complex Valvular Heart Disease 597

23 Cardiomyopathies and Pericardial Disease / Shaul Atar, Gloria Oblouk Darovic, Robert J. Siegel 601

Cardiomyopathies 601

Constrictive Pericardial Disease (Constrictive Pericarditis) 624

Pericardial Tamponade (Cardiac Tamponade) 627

24 Monitoring the Patient Following Open Heart Surgery / Robert J. March, Donna Stel, Gloria Oblouk Darovic 637

Historical Perspective 637

Preoperative Evaluation 638

Preoperative Preparation of the Patient and Family 640

Postoperative Management 640.

Notes:

Includes bibliographical references and index.

ISBN:

0721692931

OCLC:

48475519