Advanced Hemodynamics - Orlando Health

Advanced Hemodynamic Monitoring
The PAD should be used in place of wedging whenever possible
Never inflate the balloon with more than 1.5 ml of air
Only use the 1.5 ml syringe supplied with the catheter
Once the catheter is in the PAOP position it can assess pressures from the left side of the heart. The
PAOP value should be equilavent to the left atrial pressure and the left ventricular diastolic
pressure or left ventricular preload. Knowing the PAOP is important because, since it represents
preload, the clinician can assess how much volume the heart has to pump. Too much preload, or a
high PAOP, can mean there is too much volume and conversely, too little preload, or a low PAOP,
can mean that there is not enough volume. In patients with normal lungs and albumin levels,
pulmonary congestion generally will begin with PAOP values greater than 18 mm Hg and
pulmonary edema with levels greater than 24 mm Hg. However, in patients with chronic heart
failure, pulmonary edema may not begin until the PAOP pressures are greater than 30 mm Hg.
The components of the PAOP waveform are similar to that of the CVP waveform with a slight
difference in where to look for the components (See below). The A wave of the CVP waveform is
measured in the PR interval, while the A wave of the PAOP starts near the end of the QRS.
Copyright 2010 Orlando Health, Education & Development 20