02.03 Swan-Ganz Catheters for CCRN Review

Nursing Points

General

1. Swan-Ganz Catheters
   1. Invasive -> tip inserted between right ventricle and left atrium
   2. Pulmonary artery catheter -> measures pulmonary artery pressure (PAP)
      1. Systolic (squeeze) pressure (PAS)
         1. Normal = 20-30 mm Hg
         2. If elevated = lung issue (due to pulmonary vasoconstriction)
            1. Pulmonary hypertension
            2. Pulmonary hypoxia
            3. Pulmonary embolism
            4. COPD
            5. ARDS
      2. Diastolic (relaxed and filling) pressure (PAD)
         1. Normal 6-12 mm Hg
         2. If elevated = heart issue
            1. Cardiac tamponade
            2. Left ventricular failure
            3. Mitral valve disease
         3. Only SOMETIMES correlated with left ventricular end-diastolic pressure (LVedp)
   3. Cannot use Swan-Ganz with:
      1. Right bundle branch block (RBBB) -> hindrance in RV systole creates a drop in pressure = inaccurate PAD
      2. Mitral valve disease -> cause inaccurate increased pressure in left atrium due to valve issue
      3. Pulmonary hypertension
      4. Decreased left ventricular compliance
      5. Aortic insufficiency -> valve not closing -> blood backflow = increase in pressure
      6. Pulmonic insufficiency -> valve not closing -> blood backflows = drop in pressure