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+--- Thread: peep - interndoc (/showthread.php?tid=80489)
peep - interndoc - ArchivalUser - 03-24-2006
which one hemodynamic parameter that you would like to monitor:
a.sytolic BP
b. urine output
c. cardiac output
d. systemic vascular resistance
e.central venous pressure
0 - ArchivalUser - 03-24-2006
peep you will like to monitor cardiac output
but later one urinary output peep cause siadh
cardic output depends upon heart rate and stroke volume and stroke volume depend upon venous return venousreturn depend upon blod pressure so monitor systolic bllod pressure
blod pressure also depend upon cardiac output as well as systemic vascular resistance so mnitor that also
cvp also depend upon co and venous return
so basically if you monitor cardic output you monitor everything so iwill monitor cardiac output
0 - ArchivalUser - 03-24-2006
for a moniter which is easier Systolic BP or CO ?? I guess Bp is easeier as well s informative ..coz if it decrease then the perssure in chest is high
0 - ArchivalUser - 03-24-2006
we need cardiac output because peep is a procedure wher you give mechanichal ventilatation with end expiratory pressure and if you give more peep and this can cause obstructive shock meaning blood from lung cannot reach left chambers and cardiac output will decrease , so byy seeing cardiacoutput we will know whether pressure of peep is ok or not and we can adjust it.
well bp == co x svr
but bp can be falsely elevated or less due to vasoconstriction but forward flow may not be there
but if cardic output is ok means the blood must have come out of left chamber towards the body
so cardiac output is more direct and reliable
but iamnot sure of my explanation but it suits me for the timebeing
0 - ArchivalUser - 03-24-2006
actually may 20 can explain it, i suppose
0 - ArchivalUser - 03-25-2006
I thought we monitor Co in PEEP for the risk of pneumothorax.
0 - ArchivalUser - 03-25-2006
We have to measure CO because PEEP causes decreased venous return to left heart because of increased pleural pressure and decreased RV ejection due to increased transthoracic pressure(alveolar minus pleural). This causes a decrease in LV output, especially in patients with compromised LV filling.
In addition to this, PEEP when in high amounts can cause barotrauma and tension pneumothorax, which increases the pressure on the heart , causes hypoxia and impairs venous return. Another reason to watch the CO.
0 - ArchivalUser - 03-25-2006
CO is to monitored by PEEP.
0 - ArchivalUser - 03-25-2006
CVP
0 - ArchivalUser - 03-26-2006
whats the answer Interoc?