Swan ganz intro

1. Pulmonary Artery
Catheterization
RSPT 2355

2. Why use the Pulmonary Artery
Catheter?
Gives Diagnostic information on critically ill
patients…
Helps diagnose the cause of hypotension
Helps in fluid status maintenance
Give critical cardiac function data

3. Equipment
Swan-Ganz pulmonary artery catheter
2 Transducer set-ups:
CVP
PA
Cardiac monitor
Multiple waveforms
Cardiac output capabilities

7. Also known as a “Right Heart Catheter”. The position from distal
end to proximal end is: Pulmonary Artery, Right ventricle, right
atrium, vena cava, subclavian vein.
Subclavian
Tip in
Pulmonary
Artery

8. Parts:
2.Balloon
3.Openings:
a.Distal (tip)
b.Proximal
c.Injectate
4.Thermister probe
5.Ports
a.Balloon
b.Distal Port
c.Proximal port
d.Injectate
6.Electronics
connection
7.Oximeter

9. Information given by the “Swan”
Pulmonary Artery (PA) Pressure
Central Venous Pressure (CVP) Pressure
Pulmonary Capillary Wedge Pressure (PCWP or
“Wedge”)
Cardiac Output (in Liters/minute)
SVO
2
Systemic Vascular Resistance
Pulmonary Vascular Resistance
Cardiac Index

10. Information given by the “Swan”
This data can be subdivided into the
following areas:
Continuously Monitored
Intermittently Monitored
Derived by calculations

11. Information given by the “Swan”
Continuously Monitored Parameters:
Pulmonary Artery Pressure (PA)
Central Venous Pressure (CVP)
SvO2
Measurements recorded in “mmHg”
These values are a measurement of the fluid pressure in
the Pulmonary Artery, and Vena Cava respectively. These
values are useful in quantifying and diagnosing
cardiopulmonary disease.

12. Monitor showing continuously monitored PA and CVP

13. Also continuously monitored….
Although optional
SvO
2
Saturation of Venous Oxygen
Measured in the Pulmonary Artery
This reading is the Only TRUE mixed venous.

14. Intermittently monitored
Pulmonary Capillary Wedge pressure
(PCWP)
Balloon is inflated, a pressure reading is taken,
the balloon is deflated. Leaving the balloon
inflated with INFARCT the lung!

15. Intermittently monitored, cont….
Cardiac output by “Thermo dilution”
Cold fluid is injected into the “Injectate port” of the
catheter. The temperature of the fluid is measured at two
points by the thermistor on the catheter and calculated to
cardiac output.

16. Calculations
Systemic Vascular Resistance
How hard is it get blood through the vascular system?
Pulmonary Vascular Resistance
How hard does the right heart have to work to get blood
through the lungs and back to the left heart?
Cardiac Index
Careful! These calculations are
subject to error!

17. The Measured Values
CVP: Low pressure reading -
PA: Systolic/diastolic-
SvO2 ~75%
~20/10
~5 mmHg

18. The intermittent values
PCWP
Cardiac Output: normally
~8 mmHg
~6 l/m