Hemodynamic Monitoring

Mary E. Lough

Description

An evidence-based guide to hemodynamic monitoring procedures and patient care, Hemodynamic Monitoring: Evolving Technologies & Clinical Practice describes invasive, non-invasive, and minimally invasive techniques in monitoring blood pressure and oxygen levels within the circulatory system. It provides a clear, illustrated discussion of the anatomy and physiology related to hemodynamics, explains the technologies involved in each measurement, and includes quick-reference tables of normal and abnormal values. Written by cardiovascular nursing expert Mary E. Lough, Hemodynamic Monitoring is a detailed, comprehensive text designed for critical care nurses and respiratory therapists.

• Case Studies in each clinical chapter include a patient scenario with assessment details, allowing you to envision real-life patient care and prepare for adverse outcomes or complications.
• Coverage of patient safety includes a discussion of important measures that will help you provide safe and effective patient-centered care.
• UNIQUE! Coverage of patient comfort includes a discussion of methods to increase patient comfort during invasive procedures.
• Clinical Reasoning Pearls provide practical advice from experts and describe how to implement a procedure or improve patient care.
• A table of Important Values and Formulas is located inside the back cover for quick and easy reference.

Sujets

• Critical Care
• Medical
• Médecine
• Nursing
• Intensive Care

Informations

• Publié par: Mosby
• Date de parution: 16 février 2015
• Nombre de lectures: 0
• EAN13: 9780323293679
• Langue: English
• Poids de l'ouvrage: 10 Mo

Extrait

Hemodynamic Monitoring

Evolving Technologies and Clinical Practice

FIRST EDITION

Mary E. Lough, PhD, RN, CNS, CCRN, CNRN, CCNS

Critical Care Clinical Nurse Specialist, Stanford Health Care, Clinical Assistant Professor, Stanford University, Stanford, California

Table of Contents

Cover image

Inside Front Cover

Title page

Copyright

Dedication

Contributors

Reviewers

Preface and Acknowledgments PART 1: Fundamentals of Hemodynamic Monitoring

1: Physiologic Principles of Hemodynamic Monitoring

Circulation of the Blood and the Birth of Hemodynamics

Cardiac Cycle

Cardiac Valve Movements

Pressure Volume Loops

Stroke Volume and Ejection Fraction

Cardiac Output

Blood Circulation

Arterial Vascular Dynamics

Venous Vascular Dynamics

Blood Vessel Pressure, Flow, and Resistance across the Vasculature

Regulation of Blood Pressure

Neurohormonal Regulation of Blood Volume

Conclusion

2: Physical Assessment and Hemodynamic Monitoring

Key Physiologic Concepts

General Appearance

Physical Assessment

Measurements

Conclusion

3: Arterial Pressure Monitoring

Historical Milestones

Key Physiologic Concepts

Clinical Procedure and Technical Considerations

Baseline Blood Pressure

Conclusion

4: Central Venous Pressure Monitoring

Key Physiologic Concepts

Measurement of Central Venous Pressure

Central Venous Pressure Waveforms

Establishing Baseline—Normal Pressure Ranges

Assessment of Central Venous Pressure Readings

Controversies Regarding Central Venous Pressure

Troubleshooting Primary Complications of CVP Lines

Conclusion

5: Pulmonary Artery Pressure and Thermodilution Cardiac Output Monitoring

Historical Milestones

Key Physiologic Concepts

Clinical Procedures and Technical Considerations

Measurement Method

Waveform Interpretation

Measuring Thermodilution Cardiac Output

Interpretation of Data

Conclusion

6: Oxygenation and Acid–Base Balance Monitoring

Historical Milestones

Basics in Pulmonary Gas Exchange: External Respiration

Basics in Cellular Gas Exchange and Metabolism: Internal Respiration

Evaluation of Pulmonary Blood Flow and Gas Exchange

Oxygenation Monitoring

Arterial Blood Gas

Ventilation Measures and Assessment of Partial Pressure of Arterial Carbon Dioxide and End-Tidal Carbon Dioxide

The Acid–Base Balance

Arterial Blood Gas—Knowledge Application

Conclusion

7: Venous Oxygen Saturation Monitoring

Physiology of Oxygen Delivery and Consumption

Mixed Venous Oxygen Saturation

Clinical Applications of Monitoring of Saturation of Venous Oxygen

Central Venous Oxygen Saturation

Relationships between Oxygen Delivery and Oxygen Consumption

Conclusion

8: Capnography Monitoring

Respiratory Physiology

Carbon Dioxide Measurement Devices

Waveform Analysis

Clinical Application

Specialty Applications

Conclusion

9: Vasoactive Medications

Adrenergic Receptors

Vasopressor Medications

Vasodilator Medications

Positive Inotropes

Inodilators

Beta-Blockers

Alpha-Blockers

Combined Alpha–Beta Blockers

Clinical Implications

Conclusion

PART 2: Noninvasive and Minimally Invasive Hemodynamic Monitoring

10: Doppler Hemodynamic Monitoring

Historical Milestones

Key Physiologic Concepts

Doppler Background

Clinical Applications of Doppler Monitoring

Doppler Monitoring Devices

Transcutaneous Doppler Monitoring

Esophageal Doppler Monitoring

Clinician Education and Training

Future Developments

Conclusion

11: Ultrasonography-Based Hemodynamic Monitoring

Image Acquisition and Interpretation of Structures in Ultrasonography

Cardiac Assessment

Pulmonary Edema or Fluid Overload Assessment

Vascular Assessment

Conclusion

12: Arterial Waveform and Pressure-Based Hemodynamic Monitoring

Historical Milestones

Physiology of Arterial Pressure and Pulse Contour

From the Arterial Line to Noninvasive Finger Cuff

Clinical Utility

Clinical Procedure and Technical Considerations

Patient Care Considerations

Conclusion

13: Implantable Hemodynamic Monitoring

Historical Milestones in Internal Hemodynamic Monitoring

Heart Failure Management

Implantable Hemodynamic Monitoring

Using Implantable Hemodynamic Monitoring

Management Considerations

Conclusion

PART 3: Clinical Applications of Hemodynamic Monitoring

14: Hemodynamics of Mechanical Ventilation and Acute Respiratory Distress Syndrome

Physiologic Breathing

Circulating Blood Volume

Positive Pressure Ventilation

Positive End-Expiratory Pressure

Hemodynamic Alterations in Acute Respiratory Distress Syndrome

Ventilation Mode and Hemodynamic Impact

Hemodynamic Monitoring and Mechanical Ventilation

Echocardiography

Hemodynamic Changes with Ventilator Liberation

Conclusion

15: Hemodynamics of Mechanical Circulatory Support

Historical Milestones

Categories of Mechanical Circulatory Support

Short-Term Mechanical Circulatory Support Therapy

Intermediate-Term Mechanical Circulatory Support Therapy

Long-Term Mechanical Circulatory Support Therapy

SynCardia Total Artificial Heart

Future Direction

16: Hemodynamic Management Following Cardiac Surgery

Impact of Cardiac Surgery on Hemodynamics

Postoperative Hemodynamics in Patients with Normal Ventricular Function

Hemodynamics in Systolic Dysfunction: The Volume Overloaded Ventricle

Hemodynamics in Diastolic Dysfunction: The Pressure Overloaded Ventricle

Important Conditions after Cardiac Surgery: Bleeding, Tamponade, and Ventricular Failure

Conclusion

17: Hemodynamic Management of Heart Failure and Cardiogenic Shock

Subcategories of Heart Failure

Signs and Symptoms of Acute Decompensated Heart Failure and Cardiogenic Shock

Treatment of Acute Decompensated Heart Failure and Cardiogenic Shock

Conclusion

18: Hemodynamics of Acute Right Heart Failure and Pulmonary Hypertension

Historical Perspective

Key Physiologic Concepts

Diagnosis

Signs and Symptoms

Laboratory Tests for Right Heart Failure

Right Ventricular Diagnostic Tests

Treatment of Right Heart Failure

Connections Between Right Heart Failure and Pulmonary Hypertension

Hemodynamics of Pulmonary Hypertension

19: Hemodynamic Management in Hypovolemia and Trauma

Epidemiology

Etiology of Traumatic Injuries

Key Physiologic Concepts

Trauma Resuscitation Phase

Critical Care Phase

Conclusion

20: Hemodynamics of Sepsis

Historical Milestones

Epidemiology of Sepsis to Septic Shock

Sepsis Pathophysiology

Sepsis Definitions

Hemodynamics of Sepsis: Variability in Oxygen Delivery, Vascular Tone, and Arterial Volume

Managing the Hemodynamics of Sepsis, Severe Sepsis, and Septic Shock

Conclusion

21: Hemodynamic and Intracranial Dynamic Monitoring in Neurocritical Care

Historical Milestones

Central Nervous System Multimodality Monitoring

Key Physiologic Concepts

Central Nervous System Measurement Methods

Intracranial Pressure Monitoring and Cerebral Perfusion Pressure Monitoring

Brain Oxygenation

Cerebral Blood Flow

Adjunctive Measurements

Hemodynamics and Intracranial Dynamics Monitoring in Selected Neurologic Injury and Illness

Conclusion

22: Goal-Directed Hemodynamics

Heart

Volume

Vascular Tone

Goal-Directed Therapy

Historical Milestones

Shock and Oxygen Delivery

Volume Resuscitation Assessment

Oxygen Delivery and Oxyhemoglobin Dissociation

Goal-Directed Therapy and Protocols

Conclusion

Hemodynamic Equations and Normal Values

Index

Case Studies and Case Examples