Hemodynamic monitoring involves measuring factors that influence blood flow and pressure to aid in diagnosing and managing critically ill patients. It uses Doppler ultrasound to analyze blood flow spectra and determine velocity measurements. The spectral display shows velocity over time and can reveal flow direction and indices like resistive index. The document defines six types of blood flow seen: plug, laminar, parabolic, disturbed, turbulent, and pulsatile.

3. HEMODYNAMIC
MONITORING
Subject:
Applied Doppler, Vascular Doppler.
Presented By: Syed Shoaib Muhammad

4. Topics
 Hemodynamic Definition.
 Purpose.
 Types of Blood Flow
 Spectral Display

5. HEMODYNAMIC MONITORING
DEFINITION:
Measuring and monitoring the
factors that influence the force
and flow of blood.
PURPOSE:
To aid in diagnosing, monitoring
and managing critically ill patients.

6. Types of Blood Flow…….
Six types of blood flow seen in the Doppler
Ultrasound.
 Plug Flow
 Laminar Flow
 Parabolic Flow
 Disturbed Flow
 Turbulent Flow
 Pulsatile Flow

7. • The first we will discus the spectral
display.

8. Spectral Display
• X- axis – time information
• Y- axis – frequency/velocity information.
• Z- axis – amplitude information.

9. Spectral Display
Systolic Peak
Velocity
Velocity Measurements
2. End-diastolic velocity
Velocity
1. Peak systolic velocity
Mean Velocity
3. Mean velocity –
calculated by taking
the area under the
curve.
End Diastolic
Velocity
Time

10. Spectral Display
• Direction of Flow.
– Mono-phasic
– Bi-phasic
– Tri-phasic
– Bidirectional

11. Spectral Display
Mono-phasic Flow
Flow on just on side
of the Baseline.
The low resistance
blood flow.
Ideal resistance is the
end diastolic is the
half of peak systolic.
Frequency
Time

12. Spectral Display
Bi-phasic Flow
Flow start on one
side of the Baseline
and then crosses to
the other.
Frequency
Time

13. Spectral Display
Tri-phasic Flow
Flow start on one side
of the baseline side,
then crosses to the
other, then returns to
the original side.
That is the high
resistance flow.
Frequency
Time

14. Spectral Display
Bidirectional Flow
Frequency
Flow which occurs
simultaneously on
both sides of the
baseline.
Time

15. Spectrum Broadening
Occurs usually:
• As the blood decelerates in
diastole
• If sample volume is placed to
close to the vessel wall
• In small vessels (parabolic
velocity profile)
• Tortuous vessels.
• Low flow states..
• Excessive gain/power/dynamic
range

16. Spectral Display
Systolic Peak
Velocity
Resistive Index
Velocity
RI = Max – Min
Max
Mean Velocity
End Diastolic
Velocity
Time

17. Spectral Display
Systolic Peak
Velocity
Pulsatility Index
Velocity
PI = Max – Min
Mean
Mean Velocity
End Diastolic
Velocity
Time

18. Spectral Display
A/B Ratio
Systolic Peak
Velocity
Velocity
A/B ratio= Max
Min
Mean Velocity
End Diastolic
Velocity
Time

19. Types of Blood Flow
 Plug Flow
 Laminar Flow
 Parabolic Flow
 Disturbed Flow
 Turbulent Flow
 Pulsatile Flow

20. Types of Blood Flow
 Plug Flow
The flow of a body of ice or viscous fluid with no shearing
between adjacent layers; idealized flow without any mixing
of particles of fluid.

21. Types of Blood Flow
 Plug Flow

22. Types of Blood Flow
 Laminar Flow
Nonturbulent streamline flow in parallel layers

23. Types of Blood Flow
 Laminar Flow

24. Types of Blood Flow
 Parabolic Flow
pertaining to flow conditions in blood vessels. Under parabolic flow,
blood cells in the middle of the vessels move the fastest, with a gradual
decrease in flow velocity for points farther away from the center.

25. Types of Blood Flow
 Parabolic Flow

26. Types of Blood Flow
 Disturbed Flow
Two types of disturbed flow. Normal and abnormal.
Normal disturbed flow
Carotid artery.

27. Types of Blood Flow
Normal Disturbed Flow

28. Types of Blood Flow
 Disturbed Flow
Two types of disturbed flow. Normal and abnormal.
Abnormal disturbed flow

29. Types of Blood Flow
 Turbulent Flow
The motion of a fluid having local velocities and pressures that fluctuate
randomly.

30. Types of Blood Flow
 Turbulent Flow

31. Types of Blood Flow
 Pulsatile Flow
In fluid dynamics, a flow with periodic variations is known as pulsatile
flow. The cardiovascular system of chordate animals is very good
example where pulsatile flow is found

32. Types of Blood Flow
 Pulsatile Flow

33. References..
• http://en.wikipedia.org/wiki/Hemodynamics
• http://www.thefreedictionary.com/laminar
• http://medical-dictionary.thefreedictionary.com/parabolic
• http://www.thefreedictionary.com/disturbed+flow
• https://www.youtube.com/watch?v=I241zL4vJ7A