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ICU Hemodynamic Values

Drhyo 2025.11.16 22:22 Views : 15

NORMAL ICU HEMODYNAMIC VALUES

1. Cardiac Output (CO)

  • Normal: 4 – 8 L/min

CO = HR × Stroke Volume
Higher in sepsis; lower in cardiogenic shock.


2. Cardiac Index (CI)

  • Normal: 2.5 – 4.0 L/min/m²

  • Shock definition: CI < 2.2 (cardiogenic shock)

CI adjusts CO for body size → more accurate measure of perfusion.


3. Central Venous Pressure (CVP)

  • Normal: 2 – 8 mmHg

    • < 2 = hypovolemia

    • 12 = volume overload / RV strain

    • Not reliable alone—use ultrasound + clinical exam.


4. Mean Arterial Pressure (MAP)

  • Normal goal: ≥ 65 mmHg in ICU
    Lower MAP tolerated in some chronic HTN patients or young healthy individuals.


5. Pulmonary Artery Pressures (if Swan catheter)

Pulmonary Artery Pressure (PAP)

  • Normal: 15–30 / 8–15 mmHg

    • Systolic: 15–30

    • Diastolic: 8–15

Mean PAP (mPAP)

  • Normal: 10–20 mmHg

  • Pulmonary hypertension: mPAP > 20 mmHg


6. Pulmonary Capillary Wedge Pressure (PCWP)

  • Normal: 6 – 12 mmHg

  • > 18 mmHg → pulmonary edema, left-sided heart failure

  • < 5 mmHg → hypovolemia


7. Systemic Vascular Resistance (SVR)

  • Normal: 800 – 1200 dyn·s/cm⁵

  • Low SVR: septic shock, anaphylaxis

  • High SVR: cardiogenic shock, hypovolemia

SVR = (MAP − CVP) / CO × 80


8. Pulmonary Vascular Resistance (PVR)

  • Normal: 20 – 130 dyn·s/cm⁵
    Elevated in:

  • ARDS

  • Pulmonary hypertension

  • PE

  • RV failure


9. Mixed Venous Oxygen Saturation (SvO₂)

  • Normal: 60–80%

  • Low SvO₂ → low CO, anemia, or high O₂ extraction (shock)

  • High SvO₂ → sepsis, shunting, or mitochondrial dysfunction


10. Central Venous O2 Saturation (ScvO₂)

  • Normal: 70–80%

  • ScvO₂ < 70% → inadequate oxygen delivery (shock)


Quick ICU Hemodynamics Cheat-Sheet (What they mean)

Parameter Low Value Suggests High Value Suggests
CO / CI cardiogenic shock, hypovolemia sepsis, anemia, hyperdynamic
CVP hypovolemia, vasodilation RV failure, overload
PCWP hypovolemia LV failure, pulmonary edema
SVR sepsis, anaphylaxis shock states (cardio, hypo), vasoconstriction
SvO₂ low CO, increased extraction sepsis, shunt
PVR PE, ARDS pulmonary HTN

 

***ICU Pearls

  • CI is more important than CO for shock diagnosis.

  • CVP is not reliable alone—use ultrasound (IVC, RV function).

  • SvO₂ < 60% = bad; think shock, low CO.

  • SVR low = septic; SVR high = cardiogenic/hypovolemic.

  • PCWP helps separate ARDS vs cardiogenic pulmonary edema.

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