SlideShare a Scribd company logo
[From 10$/Pg] Ci Values Also Help
[From 10$/Pg] Ci Values Also HelpAmelia MangunePosted DateApr 14, 2022, 1:37
PM(edited)UnreadExplain the value of invasive hemodynamic monitoring, including a
discussion of whether an acute, chronic, or complex-care patient is a candidate for this type
of assessment. For a complex-care patient, propose an evidence-based treatment plan
regarding the hemodynamic information. What are the risk factors to take into
consideration for this patient?Clinical decision-making about optimizing treatments for
complex-care patients can be guided effectively by hemodynamic monitoring with a
pulmonary artery catheter (PAC, also known as Swan-Ganz or right heart catheter) (Saxena
et al., 2020). Based on Ingbar & Thiele (2018), pulmonary artery catheter (PAC) use in
hemodynamic monitoring is declining because clinical trials have shown no mortality
advantage. However, hemodynamic data furnished by a PAC can confirm the presence and
severity of cardiogenic shock (CS), involvement of the right ventricle, left-to-right shunting,
pulmonary artery pressures and trans-pulmonary gradient, and the pulmonary and
systemic vascular resistance. It can support recognizing acute mitral regurgitation (MR),
decreased left atrial filling pressure, and secondary occult sepsis and exclude left-to-right
shunts. Equalization of diastolic pressures indicates cardiac tamponade, but an
echocardiogram is more definitive. The detailed hemodynamic profile can be utilized to
individualize and monitor therapy and provide prognostic details, such as cardiac index and
cardiac force. The AHA currently recommends using a PAC for potential utilization in
diagnostic or CS management uncertainty cases or patients with severe CS who are
unresponsive to initial therapy. Therapeutic options for patients in CS include inotropes and
vasopressors and mechanical circulatory support (MCS) devices that pump blood from 1
vascular chamber to another to improve systemic hemodynamics. Winehouse (2021) wrote
that common PAC insertion complications include atrial and/or ventricular arrhythmias.
Less commonly, catheter misplacement or knotting can happen. Perforation of a cardiac
chamber and rupture of a cardiac valve or the pulmonary artery are rare complications that
can be fatal. Complications of catheter use include pulmonary artery rupture, pulmonary
infarction, thromboembolic events, infection, and data misinterpretation. In addition, the
benefit must be balanced against risks, as with any invasive diagnostic tool. Absolute
contraindications to PAC placement include infection at the insertion site, right ventricular
assist device, insertion during cardiopulmonary bypass, and lack of consent. Relative
contraindications include the presence of a coagulopathy (INR >1.5), thrombocytopenia
(platelet count <50,000/microL), electrolyte disturbances (hypo/hyper -kalemia, -
magnesemia, -natremia, -calcemia), and severe acid-base disturbances (e.g., pH <7.2 or
>7.5). Normal values and differential diagnoses for the alteration in normal readings for
cardiac index. According to Patel, Durland & Makaryus (2021), the cardiac index (CI)
assesses the cardiac output value based on the patient’s size. To calculate CI, divide the
cardiac output by the person’s body surface area (BSA). The normal range for CI is 2.5 to 4
L/min/m2. Cardiac output (CO) can be broken down as the product of stroke volume (SV-
blood volume ejected by one heartbeat) and heart rate (HR). Notably, this measures left
ventricular output and is a significant clinical indicator of left ventricular function.
Therefore, conditions that affect HR or SV directly impact cardiac output. Both cardiac
output and cardiac index are essential to understand if a patient’s heart pumps enough
blood and delivers enough oxygen to cells. CO and CI values also help manage specific drug
treatments, such as inotropics and vasopressors. Also, CI is a hemodynamic measurement
used to help evaluate the different forms of shock (cardiogenic, obstructive, hypovolemic,
and distributive). CO= stroke volume X heart rateCI= cardiac output/ body surface
areaDifferential diagnoses of an abnormal cardiac index reading include myocardial
ischemia, pulmonary disease (such as COPD), and patients with sleep apnea, anxiety, and
depression. In addition, patients presenting with fluid retention may complain of a leg or
abdominal swelling. Other causes of edema include venous thrombosis or insufficiency,
renal sodium retention, drug side effect (e.g., CCB), and cirrhosis (Colucci & Borlaug,
2021).ReferencesColucci, W.S. & Borlaug, B.A. (March 04, 2021). Heart failure: Clinical
manifestations and diagnosis in adults. UpToDate.
https://www.uptodate.com/contents/heart-failure-clinical-manifestations-and-diagnosis-
in-adults#H305292239Ingbar, D.H. & Thielee, H. (2018). Cardiogenic shock and pulmonary
edema. In Jameson, J.L., Kasper, D.L., Longo, D.L., Fauci, A.S., Hauser, S.L. & Loscalzo, J.
(Eds). Harrison’s Principles of Internal Medicine (20th Ed, Vol.2, Part 1, Chap.298, pp.448).
McGraw-Hill Education. Patel, N., Durland, J. & Makaryus, A.N. (September 28, 2021).
Physiology, Cardiac index. https://www.ncbi.nlm.nih.gov/books/NBK539905/Saxena, A.,
Garan, A.R., Kapur, N.K., O’Neill, W.W., Lindenfeeeld, A., Pinney, S.P., Uriel, N., Burkoff, D. &
Kern,M. (April 6, 2020). Value of hemodynamic monitoring in patients with cardiogenic
shock undergoing mechanical circulatory support.
https://doi.org/10.1161/CIRCULATIONAHA.119.043080/ Circulation;141:1184–
1197Weinhouse, G.L. (June 24, 2021). Pulmonary artery catheterization: Indications,
contraindications, and complications in adults. UpToDate.
https://www.uptodate.com/contents/pulmonary-artery-catheterization-indications-
contraindications-and-complications-in-
adults?search=pulmonary%20artery%20catheter&source=search_result&selectedTitle=1~
150&usage_type=default&display_rank=1#H13

More Related Content

Similar to Ci Values Also Help.docx

Resuscitaion global vs_regional
Resuscitaion global vs_regionalResuscitaion global vs_regional
Resuscitaion global vs_regional
OSCHOCA
 
Retraso de cx
Retraso de cxRetraso de cx
Retraso de cx
Oliver Arteaga
 
Hemodynamics of valvular disorders as measured by cardiac catheterization - U...
Hemodynamics of valvular disorders as measured by cardiac catheterization - U...Hemodynamics of valvular disorders as measured by cardiac catheterization - U...
Hemodynamics of valvular disorders as measured by cardiac catheterization - U...
franciscomaan
 
management of LV thrombus
management of LV thrombusmanagement of LV thrombus
management of LV thrombus
Astrid Pramudya
 
Peripheral Artery Disease.pptx
Peripheral Artery Disease.pptxPeripheral Artery Disease.pptx
Peripheral Artery Disease.pptx
ArunDeva8
 
Fluid Management in Patients with Chronic Heart Failure (2).pdf
Fluid Management in Patients with Chronic Heart Failure (2).pdfFluid Management in Patients with Chronic Heart Failure (2).pdf
Fluid Management in Patients with Chronic Heart Failure (2).pdf
John Nguyen
 
Fluid Management in Patients with Chronic Heart Failure.pdf
Fluid Management in Patients with Chronic Heart Failure.pdfFluid Management in Patients with Chronic Heart Failure.pdf
Fluid Management in Patients with Chronic Heart Failure.pdf
John Nguyen
 
Cardiogenic shock aha 2019
Cardiogenic shock aha 2019Cardiogenic shock aha 2019
Cardiogenic shock aha 2019
Ricardo Garcia
 
CIR.0000000000000921.pdf
CIR.0000000000000921.pdfCIR.0000000000000921.pdf
CIR.0000000000000921.pdf
cikKahadi
 
JAHA.119.011991.pdf
JAHA.119.011991.pdfJAHA.119.011991.pdf
JAHA.119.011991.pdf
AndiHarianto3
 
Reversal of warfarin associated coagulopathy prothrombin complex concentrates
Reversal of warfarin associated coagulopathy prothrombin complex concentratesReversal of warfarin associated coagulopathy prothrombin complex concentrates
Reversal of warfarin associated coagulopathy prothrombin complex concentrates
TÀI LIỆU NGÀNH MAY
 
jcm-12-00260.pdf
jcm-12-00260.pdfjcm-12-00260.pdf
Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...
Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...
Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...
ssuser36abb7
 
Impact_of_amount_of_fluid_for_circulatory_resuscit.pdf
Impact_of_amount_of_fluid_for_circulatory_resuscit.pdfImpact_of_amount_of_fluid_for_circulatory_resuscit.pdf
Impact_of_amount_of_fluid_for_circulatory_resuscit.pdf
KhalilSemlali
 
M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...
M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...
M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...
M. Luisetto Pharm.D.Spec. Pharmacology
 
Vpc
VpcVpc
Shock Trial
Shock TrialShock Trial
Shock Trial
Rashidi Ahmad
 
The Emerging Role of BIomarkers and Bio-Impedance
The Emerging Role of BIomarkers and Bio-ImpedanceThe Emerging Role of BIomarkers and Bio-Impedance
The Emerging Role of BIomarkers and Bio-Impedance
drucsamal
 
Cardiopulmonary testing preoperative
Cardiopulmonary testing preoperativeCardiopulmonary testing preoperative
Cardiopulmonary testing preoperative
DR RML DELHI
 
Nursing Care of Patients after CABG Surgery.pptx
Nursing Care of Patients after CABG Surgery.pptxNursing Care of Patients after CABG Surgery.pptx
Nursing Care of Patients after CABG Surgery.pptx
Vijayakrishnan Ramakrishnan
 

Similar to Ci Values Also Help.docx (20)

Resuscitaion global vs_regional
Resuscitaion global vs_regionalResuscitaion global vs_regional
Resuscitaion global vs_regional
 
Retraso de cx
Retraso de cxRetraso de cx
Retraso de cx
 
Hemodynamics of valvular disorders as measured by cardiac catheterization - U...
Hemodynamics of valvular disorders as measured by cardiac catheterization - U...Hemodynamics of valvular disorders as measured by cardiac catheterization - U...
Hemodynamics of valvular disorders as measured by cardiac catheterization - U...
 
management of LV thrombus
management of LV thrombusmanagement of LV thrombus
management of LV thrombus
 
Peripheral Artery Disease.pptx
Peripheral Artery Disease.pptxPeripheral Artery Disease.pptx
Peripheral Artery Disease.pptx
 
Fluid Management in Patients with Chronic Heart Failure (2).pdf
Fluid Management in Patients with Chronic Heart Failure (2).pdfFluid Management in Patients with Chronic Heart Failure (2).pdf
Fluid Management in Patients with Chronic Heart Failure (2).pdf
 
Fluid Management in Patients with Chronic Heart Failure.pdf
Fluid Management in Patients with Chronic Heart Failure.pdfFluid Management in Patients with Chronic Heart Failure.pdf
Fluid Management in Patients with Chronic Heart Failure.pdf
 
Cardiogenic shock aha 2019
Cardiogenic shock aha 2019Cardiogenic shock aha 2019
Cardiogenic shock aha 2019
 
CIR.0000000000000921.pdf
CIR.0000000000000921.pdfCIR.0000000000000921.pdf
CIR.0000000000000921.pdf
 
JAHA.119.011991.pdf
JAHA.119.011991.pdfJAHA.119.011991.pdf
JAHA.119.011991.pdf
 
Reversal of warfarin associated coagulopathy prothrombin complex concentrates
Reversal of warfarin associated coagulopathy prothrombin complex concentratesReversal of warfarin associated coagulopathy prothrombin complex concentrates
Reversal of warfarin associated coagulopathy prothrombin complex concentrates
 
jcm-12-00260.pdf
jcm-12-00260.pdfjcm-12-00260.pdf
jcm-12-00260.pdf
 
Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...
Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...
Cathet Cardio Intervent - 2019 - Baran - SCAI clinical expert consensus state...
 
Impact_of_amount_of_fluid_for_circulatory_resuscit.pdf
Impact_of_amount_of_fluid_for_circulatory_resuscit.pdfImpact_of_amount_of_fluid_for_circulatory_resuscit.pdf
Impact_of_amount_of_fluid_for_circulatory_resuscit.pdf
 
M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...
M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...
M. luisetto (2017) sudden death heart pathology – a new research hipotesys in...
 
Vpc
VpcVpc
Vpc
 
Shock Trial
Shock TrialShock Trial
Shock Trial
 
The Emerging Role of BIomarkers and Bio-Impedance
The Emerging Role of BIomarkers and Bio-ImpedanceThe Emerging Role of BIomarkers and Bio-Impedance
The Emerging Role of BIomarkers and Bio-Impedance
 
Cardiopulmonary testing preoperative
Cardiopulmonary testing preoperativeCardiopulmonary testing preoperative
Cardiopulmonary testing preoperative
 
Nursing Care of Patients after CABG Surgery.pptx
Nursing Care of Patients after CABG Surgery.pptxNursing Care of Patients after CABG Surgery.pptx
Nursing Care of Patients after CABG Surgery.pptx
 

More from studywriters

inventor who is currently living in Northeast Ohio and answer.docx
inventor who is currently living in Northeast Ohio and answer.docxinventor who is currently living in Northeast Ohio and answer.docx
inventor who is currently living in Northeast Ohio and answer.docx
studywriters
 
Health care organizations strive to create a culture of.docx
Health care organizations strive to create a culture of.docxHealth care organizations strive to create a culture of.docx
Health care organizations strive to create a culture of.docx
studywriters
 
Health care has become to depend on information technology.docx
Health care has become to depend on information technology.docxHealth care has become to depend on information technology.docx
Health care has become to depend on information technology.docx
studywriters
 
Health care facilities treat many types of For.docx
Health care facilities treat many types of For.docxHealth care facilities treat many types of For.docx
Health care facilities treat many types of For.docx
studywriters
 
Health Belief Model.docx
Health Belief Model.docxHealth Belief Model.docx
Health Belief Model.docx
studywriters
 
Health assessment.docx
Health assessment.docxHealth assessment.docx
Health assessment.docx
studywriters
 
Health and Professional Ethics.docx
Health and Professional Ethics.docxHealth and Professional Ethics.docx
Health and Professional Ethics.docx
studywriters
 
Health and Advocacy.docx
Health and Advocacy.docxHealth and Advocacy.docx
Health and Advocacy.docx
studywriters
 
he brain changes as we Explain the changes in.docx
he brain changes as we Explain the changes in.docxhe brain changes as we Explain the changes in.docx
he brain changes as we Explain the changes in.docx
studywriters
 
HCR 210 Week 1 DQs.docx
HCR 210 Week 1 DQs.docxHCR 210 Week 1 DQs.docx
HCR 210 Week 1 DQs.docx
studywriters
 
HCS 131 Course Presentation.docx
HCS 131 Course Presentation.docxHCS 131 Course Presentation.docx
HCS 131 Course Presentation.docx
studywriters
 
Hawksbill sea turtle Conservation Management.docx
Hawksbill sea turtle Conservation Management.docxHawksbill sea turtle Conservation Management.docx
Hawksbill sea turtle Conservation Management.docx
studywriters
 
Is social media more beneficial or more harmful to our.docx
Is social media more beneficial or more harmful to our.docxIs social media more beneficial or more harmful to our.docx
Is social media more beneficial or more harmful to our.docx
studywriters
 
Is relevant to Teslas.docx
Is relevant to Teslas.docxIs relevant to Teslas.docx
Is relevant to Teslas.docx
studywriters
 
Having more clarity about helps one become a better.docx
Having more clarity about helps one become a better.docxHaving more clarity about helps one become a better.docx
Having more clarity about helps one become a better.docx
studywriters
 
Is prostitution morally Should we legalize.docx
Is prostitution morally Should we legalize.docxIs prostitution morally Should we legalize.docx
Is prostitution morally Should we legalize.docx
studywriters
 
Is Moral Anger.docx
Is Moral Anger.docxIs Moral Anger.docx
Is Moral Anger.docx
studywriters
 
Is Price gouging criminal or is it the free market.docx
Is Price gouging criminal or is it the free market.docxIs Price gouging criminal or is it the free market.docx
Is Price gouging criminal or is it the free market.docx
studywriters
 
is never total and never The Social.docx
is never total and never The Social.docxis never total and never The Social.docx
is never total and never The Social.docx
studywriters
 
is medicine and doctors need to prescribe.docx
is medicine and doctors need to prescribe.docxis medicine and doctors need to prescribe.docx
is medicine and doctors need to prescribe.docx
studywriters
 

More from studywriters (20)

inventor who is currently living in Northeast Ohio and answer.docx
inventor who is currently living in Northeast Ohio and answer.docxinventor who is currently living in Northeast Ohio and answer.docx
inventor who is currently living in Northeast Ohio and answer.docx
 
Health care organizations strive to create a culture of.docx
Health care organizations strive to create a culture of.docxHealth care organizations strive to create a culture of.docx
Health care organizations strive to create a culture of.docx
 
Health care has become to depend on information technology.docx
Health care has become to depend on information technology.docxHealth care has become to depend on information technology.docx
Health care has become to depend on information technology.docx
 
Health care facilities treat many types of For.docx
Health care facilities treat many types of For.docxHealth care facilities treat many types of For.docx
Health care facilities treat many types of For.docx
 
Health Belief Model.docx
Health Belief Model.docxHealth Belief Model.docx
Health Belief Model.docx
 
Health assessment.docx
Health assessment.docxHealth assessment.docx
Health assessment.docx
 
Health and Professional Ethics.docx
Health and Professional Ethics.docxHealth and Professional Ethics.docx
Health and Professional Ethics.docx
 
Health and Advocacy.docx
Health and Advocacy.docxHealth and Advocacy.docx
Health and Advocacy.docx
 
he brain changes as we Explain the changes in.docx
he brain changes as we Explain the changes in.docxhe brain changes as we Explain the changes in.docx
he brain changes as we Explain the changes in.docx
 
HCR 210 Week 1 DQs.docx
HCR 210 Week 1 DQs.docxHCR 210 Week 1 DQs.docx
HCR 210 Week 1 DQs.docx
 
HCS 131 Course Presentation.docx
HCS 131 Course Presentation.docxHCS 131 Course Presentation.docx
HCS 131 Course Presentation.docx
 
Hawksbill sea turtle Conservation Management.docx
Hawksbill sea turtle Conservation Management.docxHawksbill sea turtle Conservation Management.docx
Hawksbill sea turtle Conservation Management.docx
 
Is social media more beneficial or more harmful to our.docx
Is social media more beneficial or more harmful to our.docxIs social media more beneficial or more harmful to our.docx
Is social media more beneficial or more harmful to our.docx
 
Is relevant to Teslas.docx
Is relevant to Teslas.docxIs relevant to Teslas.docx
Is relevant to Teslas.docx
 
Having more clarity about helps one become a better.docx
Having more clarity about helps one become a better.docxHaving more clarity about helps one become a better.docx
Having more clarity about helps one become a better.docx
 
Is prostitution morally Should we legalize.docx
Is prostitution morally Should we legalize.docxIs prostitution morally Should we legalize.docx
Is prostitution morally Should we legalize.docx
 
Is Moral Anger.docx
Is Moral Anger.docxIs Moral Anger.docx
Is Moral Anger.docx
 
Is Price gouging criminal or is it the free market.docx
Is Price gouging criminal or is it the free market.docxIs Price gouging criminal or is it the free market.docx
Is Price gouging criminal or is it the free market.docx
 
is never total and never The Social.docx
is never total and never The Social.docxis never total and never The Social.docx
is never total and never The Social.docx
 
is medicine and doctors need to prescribe.docx
is medicine and doctors need to prescribe.docxis medicine and doctors need to prescribe.docx
is medicine and doctors need to prescribe.docx
 

Recently uploaded

Liberal Approach to the Study of Indian Politics.pdf
Liberal Approach to the Study of Indian Politics.pdfLiberal Approach to the Study of Indian Politics.pdf
Liberal Approach to the Study of Indian Politics.pdf
WaniBasim
 
The History of Stoke Newington Street Names
The History of Stoke Newington Street NamesThe History of Stoke Newington Street Names
The History of Stoke Newington Street Names
History of Stoke Newington
 
How to deliver Powerpoint Presentations.pptx
How to deliver Powerpoint  Presentations.pptxHow to deliver Powerpoint  Presentations.pptx
How to deliver Powerpoint Presentations.pptx
HajraNaeem15
 
Natural birth techniques - Mrs.Akanksha Trivedi Rama University
Natural birth techniques - Mrs.Akanksha Trivedi Rama UniversityNatural birth techniques - Mrs.Akanksha Trivedi Rama University
Natural birth techniques - Mrs.Akanksha Trivedi Rama University
Akanksha trivedi rama nursing college kanpur.
 
clinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdfclinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdf
Priyankaranawat4
 
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
Nguyen Thanh Tu Collection
 
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
Nguyen Thanh Tu Collection
 
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
Chapter 4 - Islamic Financial Institutions in Malaysia.pptxChapter 4 - Islamic Financial Institutions in Malaysia.pptx
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
Mohd Adib Abd Muin, Senior Lecturer at Universiti Utara Malaysia
 
Leveraging Generative AI to Drive Nonprofit Innovation
Leveraging Generative AI to Drive Nonprofit InnovationLeveraging Generative AI to Drive Nonprofit Innovation
Leveraging Generative AI to Drive Nonprofit Innovation
TechSoup
 
C1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptx
C1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptxC1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptx
C1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptx
mulvey2
 
Cognitive Development Adolescence Psychology
Cognitive Development Adolescence PsychologyCognitive Development Adolescence Psychology
Cognitive Development Adolescence Psychology
paigestewart1632
 
คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1
คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1
คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1
สมใจ จันสุกสี
 
How to Make a Field Mandatory in Odoo 17
How to Make a Field Mandatory in Odoo 17How to Make a Field Mandatory in Odoo 17
How to Make a Field Mandatory in Odoo 17
Celine George
 
PCOS corelations and management through Ayurveda.
PCOS corelations and management through Ayurveda.PCOS corelations and management through Ayurveda.
PCOS corelations and management through Ayurveda.
Dr. Shivangi Singh Parihar
 
Digital Artefact 1 - Tiny Home Environmental Design
Digital Artefact 1 - Tiny Home Environmental DesignDigital Artefact 1 - Tiny Home Environmental Design
Digital Artefact 1 - Tiny Home Environmental Design
amberjdewit93
 
How to Build a Module in Odoo 17 Using the Scaffold Method
How to Build a Module in Odoo 17 Using the Scaffold MethodHow to Build a Module in Odoo 17 Using the Scaffold Method
How to Build a Module in Odoo 17 Using the Scaffold Method
Celine George
 
BBR 2024 Summer Sessions Interview Training
BBR  2024 Summer Sessions Interview TrainingBBR  2024 Summer Sessions Interview Training
BBR 2024 Summer Sessions Interview Training
Katrina Pritchard
 
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptxChapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Denish Jangid
 
A Independência da América Espanhola LAPBOOK.pdf
A Independência da América Espanhola LAPBOOK.pdfA Independência da América Espanhola LAPBOOK.pdf
A Independência da América Espanhola LAPBOOK.pdf
Jean Carlos Nunes Paixão
 
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdfANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
Priyankaranawat4
 

Recently uploaded (20)

Liberal Approach to the Study of Indian Politics.pdf
Liberal Approach to the Study of Indian Politics.pdfLiberal Approach to the Study of Indian Politics.pdf
Liberal Approach to the Study of Indian Politics.pdf
 
The History of Stoke Newington Street Names
The History of Stoke Newington Street NamesThe History of Stoke Newington Street Names
The History of Stoke Newington Street Names
 
How to deliver Powerpoint Presentations.pptx
How to deliver Powerpoint  Presentations.pptxHow to deliver Powerpoint  Presentations.pptx
How to deliver Powerpoint Presentations.pptx
 
Natural birth techniques - Mrs.Akanksha Trivedi Rama University
Natural birth techniques - Mrs.Akanksha Trivedi Rama UniversityNatural birth techniques - Mrs.Akanksha Trivedi Rama University
Natural birth techniques - Mrs.Akanksha Trivedi Rama University
 
clinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdfclinical examination of hip joint (1).pdf
clinical examination of hip joint (1).pdf
 
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
 
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
BÀI TẬP BỔ TRỢ TIẾNG ANH LỚP 9 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2024-2025 - ...
 
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
Chapter 4 - Islamic Financial Institutions in Malaysia.pptxChapter 4 - Islamic Financial Institutions in Malaysia.pptx
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
 
Leveraging Generative AI to Drive Nonprofit Innovation
Leveraging Generative AI to Drive Nonprofit InnovationLeveraging Generative AI to Drive Nonprofit Innovation
Leveraging Generative AI to Drive Nonprofit Innovation
 
C1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptx
C1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptxC1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptx
C1 Rubenstein AP HuG xxxxxxxxxxxxxx.pptx
 
Cognitive Development Adolescence Psychology
Cognitive Development Adolescence PsychologyCognitive Development Adolescence Psychology
Cognitive Development Adolescence Psychology
 
คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1
คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1
คำศัพท์ คำพื้นฐานการอ่าน ภาษาอังกฤษ ระดับชั้น ม.1
 
How to Make a Field Mandatory in Odoo 17
How to Make a Field Mandatory in Odoo 17How to Make a Field Mandatory in Odoo 17
How to Make a Field Mandatory in Odoo 17
 
PCOS corelations and management through Ayurveda.
PCOS corelations and management through Ayurveda.PCOS corelations and management through Ayurveda.
PCOS corelations and management through Ayurveda.
 
Digital Artefact 1 - Tiny Home Environmental Design
Digital Artefact 1 - Tiny Home Environmental DesignDigital Artefact 1 - Tiny Home Environmental Design
Digital Artefact 1 - Tiny Home Environmental Design
 
How to Build a Module in Odoo 17 Using the Scaffold Method
How to Build a Module in Odoo 17 Using the Scaffold MethodHow to Build a Module in Odoo 17 Using the Scaffold Method
How to Build a Module in Odoo 17 Using the Scaffold Method
 
BBR 2024 Summer Sessions Interview Training
BBR  2024 Summer Sessions Interview TrainingBBR  2024 Summer Sessions Interview Training
BBR 2024 Summer Sessions Interview Training
 
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptxChapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering.pptx
 
A Independência da América Espanhola LAPBOOK.pdf
A Independência da América Espanhola LAPBOOK.pdfA Independência da América Espanhola LAPBOOK.pdf
A Independência da América Espanhola LAPBOOK.pdf
 
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdfANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
 

Ci Values Also Help.docx

  • 1. [From 10$/Pg] Ci Values Also Help [From 10$/Pg] Ci Values Also HelpAmelia MangunePosted DateApr 14, 2022, 1:37 PM(edited)UnreadExplain the value of invasive hemodynamic monitoring, including a discussion of whether an acute, chronic, or complex-care patient is a candidate for this type of assessment. For a complex-care patient, propose an evidence-based treatment plan regarding the hemodynamic information. What are the risk factors to take into consideration for this patient?Clinical decision-making about optimizing treatments for complex-care patients can be guided effectively by hemodynamic monitoring with a pulmonary artery catheter (PAC, also known as Swan-Ganz or right heart catheter) (Saxena et al., 2020). Based on Ingbar & Thiele (2018), pulmonary artery catheter (PAC) use in hemodynamic monitoring is declining because clinical trials have shown no mortality advantage. However, hemodynamic data furnished by a PAC can confirm the presence and severity of cardiogenic shock (CS), involvement of the right ventricle, left-to-right shunting, pulmonary artery pressures and trans-pulmonary gradient, and the pulmonary and systemic vascular resistance. It can support recognizing acute mitral regurgitation (MR), decreased left atrial filling pressure, and secondary occult sepsis and exclude left-to-right shunts. Equalization of diastolic pressures indicates cardiac tamponade, but an echocardiogram is more definitive. The detailed hemodynamic profile can be utilized to individualize and monitor therapy and provide prognostic details, such as cardiac index and cardiac force. The AHA currently recommends using a PAC for potential utilization in diagnostic or CS management uncertainty cases or patients with severe CS who are unresponsive to initial therapy. Therapeutic options for patients in CS include inotropes and vasopressors and mechanical circulatory support (MCS) devices that pump blood from 1 vascular chamber to another to improve systemic hemodynamics. Winehouse (2021) wrote that common PAC insertion complications include atrial and/or ventricular arrhythmias. Less commonly, catheter misplacement or knotting can happen. Perforation of a cardiac chamber and rupture of a cardiac valve or the pulmonary artery are rare complications that can be fatal. Complications of catheter use include pulmonary artery rupture, pulmonary infarction, thromboembolic events, infection, and data misinterpretation. In addition, the benefit must be balanced against risks, as with any invasive diagnostic tool. Absolute contraindications to PAC placement include infection at the insertion site, right ventricular assist device, insertion during cardiopulmonary bypass, and lack of consent. Relative contraindications include the presence of a coagulopathy (INR >1.5), thrombocytopenia (platelet count <50,000/microL), electrolyte disturbances (hypo/hyper -kalemia, -
  • 2. magnesemia, -natremia, -calcemia), and severe acid-base disturbances (e.g., pH <7.2 or >7.5). Normal values and differential diagnoses for the alteration in normal readings for cardiac index. According to Patel, Durland & Makaryus (2021), the cardiac index (CI) assesses the cardiac output value based on the patient’s size. To calculate CI, divide the cardiac output by the person’s body surface area (BSA). The normal range for CI is 2.5 to 4 L/min/m2. Cardiac output (CO) can be broken down as the product of stroke volume (SV- blood volume ejected by one heartbeat) and heart rate (HR). Notably, this measures left ventricular output and is a significant clinical indicator of left ventricular function. Therefore, conditions that affect HR or SV directly impact cardiac output. Both cardiac output and cardiac index are essential to understand if a patient’s heart pumps enough blood and delivers enough oxygen to cells. CO and CI values also help manage specific drug treatments, such as inotropics and vasopressors. Also, CI is a hemodynamic measurement used to help evaluate the different forms of shock (cardiogenic, obstructive, hypovolemic, and distributive). CO= stroke volume X heart rateCI= cardiac output/ body surface areaDifferential diagnoses of an abnormal cardiac index reading include myocardial ischemia, pulmonary disease (such as COPD), and patients with sleep apnea, anxiety, and depression. In addition, patients presenting with fluid retention may complain of a leg or abdominal swelling. Other causes of edema include venous thrombosis or insufficiency, renal sodium retention, drug side effect (e.g., CCB), and cirrhosis (Colucci & Borlaug, 2021).ReferencesColucci, W.S. & Borlaug, B.A. (March 04, 2021). Heart failure: Clinical manifestations and diagnosis in adults. UpToDate. https://www.uptodate.com/contents/heart-failure-clinical-manifestations-and-diagnosis- in-adults#H305292239Ingbar, D.H. & Thielee, H. (2018). Cardiogenic shock and pulmonary edema. In Jameson, J.L., Kasper, D.L., Longo, D.L., Fauci, A.S., Hauser, S.L. & Loscalzo, J. (Eds). Harrison’s Principles of Internal Medicine (20th Ed, Vol.2, Part 1, Chap.298, pp.448). McGraw-Hill Education. Patel, N., Durland, J. & Makaryus, A.N. (September 28, 2021). Physiology, Cardiac index. https://www.ncbi.nlm.nih.gov/books/NBK539905/Saxena, A., Garan, A.R., Kapur, N.K., O’Neill, W.W., Lindenfeeeld, A., Pinney, S.P., Uriel, N., Burkoff, D. & Kern,M. (April 6, 2020). Value of hemodynamic monitoring in patients with cardiogenic shock undergoing mechanical circulatory support. https://doi.org/10.1161/CIRCULATIONAHA.119.043080/ Circulation;141:1184– 1197Weinhouse, G.L. (June 24, 2021). Pulmonary artery catheterization: Indications, contraindications, and complications in adults. UpToDate. https://www.uptodate.com/contents/pulmonary-artery-catheterization-indications- contraindications-and-complications-in- adults?search=pulmonary%20artery%20catheter&source=search_result&selectedTitle=1~ 150&usage_type=default&display_rank=1#H13