by sonnyluv

Hey all!

Starting in a new I.C.U tomorrow and have the written portion of the clinical competency. Am I nervous!
So I am studying hemodynamic monitoring and I can't seem to find any literature, online or off, about mean pulmonary artery pressure: How to measure, significance of values, and alterations of.

Would I simply just put a line through the middle of the PAP- or do I average the A-wave like in PAWP.

Thanks for any advice given- getting close to the wire here (alright pun intended!) and this one is a doozy. Even pacep.org doesn't have and they seem to be pretty thorough on the whole topic.


Thanks,

Sonny

Re: Swan freestyle: Does Mean PAP Exist?

pulmonary artery pressure is an arterial pressure, so like a regular arterial pressure, the mean is a calculated number: [PAS + (PAD x 2)] / 3. Hope this helps!

Re: Swan freestyle: Does Mean PAP Exist?

The significance is that the mean pressure is the driving pressure gradient which creates forward flow. Factors which affect the above equation alter it.

Pressure = Flow X Resistance

Changes in flow (cardiac output) or resistance (pulm vasc tone, left heart compliance etc) drive the value up or down.

Re: Swan freestyle: Does Mean PAP Exist?

perfect! Range is 10-20mmhg.

Re: Swan freestyle: Does Mean PAP Exist?

Originally Posted by NurseJenkins

pulmonary artery pressure is an arterial pressure, so like a regular arterial pressure, the mean is a calculated number: [PAS + (PAD x 2)] / 3. Hope this helps!

couldn't have said this better. Great job!

Re: Swan freestyle: Does Mean PAP Exist?

you can say that again! no better way to explain it than this way!

Re: Swan freestyle: Does Mean PAP Exist?

You might find the Pulmonary Artery Catheter Education Project website helpful.

Re: Swan freestyle: Does Mean PAP Exist?

This newer formula corrects mean pressures for HR as well...which is more acurate with the changes in filling times that effect C.O. : DP + [0.33 + (HR x 0.0012)] x [SP] where DP is diastolic pressure, HR is heart rate, and SP is systolic pressure.

Re: Swan freestyle: Does Mean PAP Exist?

You couldn't find out online how to calculate mPAP? I just googled and the first several references listed the formula to calculate it.

As for significance: anything that increases mPAP is also putting more stress on the right ventricle. Patients with bad hearts and/or pulmonary hypertension may need pulmonary vasodilation to reduce the RV afterload.