Advanced Hemodynamics - Orlando Health

Advanced Hemodynamic Monitoring
Contraindications for PAC
Currently there are no absolute contraindications to inserting a PAC. However, its use must be
justified in that its use is imperative to diagnostic or treatment strategies. Some of the relative
contraindications include the following:
Patients with severe coagulopathies
Patients with a prosthetic right heart valve
Patients with an endocardial pacemaker
Patients with severe vascular disease
Patients with pulmonary hypertension
Patients in a location that lacks the availability of physicians trained and skilled in insertion
and flotation and the principles of blood flow, measurement of intravascular pressures, and
interpretation of hemodynamic data
PAC Set Up and Insertion
As Replicated from the Fundamentals of Hemodynamics SLP:
Hemodynamic pressure monitoring systems detect changes in pressure within the vascular system
and convert those changes into digital signals. The digital signals are then displayed on a monitor as
waveforms and numeric data.
What will you see:
There are several types of PA catheters with various features and varying numbers of lumens. It is a
long hollow flexible catheter that is generally yellow in color. The PAC can have varying numbers
of pigtails with corresponding lumens and tunnels. Typically you may see a PAC with four or five
lumens each representing the following:
Proximal injectate port- used for monitoring right atrial pressures
PA distal port- used for measuring PA systolic, diastolic, and mean pressures
Balloon inflation port- used to inflate the balloon for the purposes of flotation during
insertion and obtaining PA occlusion pressures (also known as pulmonary capillary wedge
pressure or pulmonary artery occlusion pressure [PAOP/PAWP].
Thermistor wire connector- used for connecting to a cable for measuring cardiac output and
blood temperature.
The PA catheter will have a series of encircling black lines, which allow the clinician to estimate
the location of the catheter tip in centimeters. Each thin black line will equal 10 cm, while the
thicker black lines will equal 50 cm.
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