Hemodynamics Is defined as the study of the forces involved in blood circulation. Hemodynamic monitoring is used to assess cardiovascular function in the critically ill or unstable client It is indicated when standard vital signs measurements are not adequate to evaluate changes in cardiovascular status.

Purpose The main goals of invasive hemodynamic monitoring are to evaluate cardiac function, the condition of the circulatory system, and the clients response to interventions Provide additional information which establishes or expands a given diagnosis Provides a physiological rationale for a selected therapy Allows a rapid determination of the response to therapy or suggest a change in the response

Types Intrarterial Blood Pressure Monitoring Central Venous Pressure Monitoring Pulmonary Artery Pressure Monitoring The hemodynamic pressures include heart rate, arterial blood pressure, central blood pressure, pulmonary pressures, and cardiac output

Direct versus Derived Parameters Direct hemodynamic parameters are obtained straight from the monitoring device for example the heart rate, and various pressures such as arterial and venous pressures Derived hemodynamic pressures are calculated using the direct hemodynamic data; they include such measurements such as cardiac index, mean arterial blood pressure (MAP), and stroke volume (SV)

Hemodynamic Monitoring Systems Measure the pressures within the vessel and converts this signal into an electrical waveform that is amplified and displayed The electrical signal may be graphically recorded on pressure graph paper and displayed numerically on the monitor System components include an invasive catheter threaded into artery or vein connected to a transducer by stiff high-pressure tubing

Hemodynamic Monitoring Systems The pressure transducer translates pressure measurements into an electrical signal that is in turn relayed to the monitor Additional components include stopcocks and a continuous flush system with heparinized saline and an infusion pressure bag to keep clots from forming in the catheter

Leveling the Transducer Is important to ensure accurate readings The point used as a constant reference is the level of the right atrium It is located by intersecting two imaginary lines: one drawn down the lateral chest wall from the clients 4th intercostal space, the other line is mid chest level (the midaxillary line) Once located, this junction is marked with ink or tape and used consistently for pressure readings