PA Catheter and Tailored Therapy

Rationale

  • Cardiac output (CO) = SV × HR; optimize SV (and thereby CO) by manipulating preload/ LVEDV (w/ IVF, diuretics), contractility (w/ inotropes), & afterload (w/ vasodilators)
  • Balloon at catheter tip inflated → floats into “wedge” position. Column of blood extends from tip of catheter, through pulm venous circulation to a point just prox to LA. Under conditions of no flow, PCWP ≈ LA pressure ≈ LVEDP, which is proportional to LVEDV.
  • Situations in which these basic assumptions fail:
    1. Catheter tip not in West lung zone 3 (and ∴ PCWP = pressure ≠ LA pressure); clues include lack of