Pulmonary artery catheter (Swan-Ganz) interpretation for nurses: insertion waveform progression, PAOP/wedge pressure, cardiac output thermodilution, mixed venous oxygen saturation, and clinical application in cardiogenic and septic shock.
Right atrium (RA)
Low-amplitude a-wave, c-wave, v-wave pattern; mean ~2–8 mmHg
Right ventricle (RV)
High systolic, near-zero diastolic; systolic matches PA systolic; no diastolic plateau
Pulmonary artery (PA)
Diastolic notch appears — distinguishes PA from RV; diastolic plateau present
Wedge position (PAOP)
Low-pressure a and v waves; balloon inflated, tip occludes PA; reflects LVEDP when MV is open
RA pressure (CVP)
Normal: 2–8 mmHg
Elevated = RV failure, tamponade, fluid overload
RV systolic
Normal: 15–25 mmHg
Elevated = pulmonary hypertension, PE
PA systolic / diastolic
Normal: 15–25 / 8–15 mmHg
Pulmonary HTN if PA systolic >25 at rest
PAOP (wedge)
Normal: ≤18 mmHg
>18 = cardiogenic pulmonary edema; <6 = hypovolemia
Cardiac output (CO)
Normal: 4–8 L/min
Low CO + elevated PAOP = cardiogenic shock
Cardiac index (CI)
Normal: 2.5–4.0 L/min/m²
<2.2 with hypoperfusion = cardiogenic shock threshold
SVR
Normal: 800–1200 dynes·sec/cm⁵
Low = distributive; High = cardiogenic or hypovolemic
SvO2
Normal: 65–75%
<60% = high extraction (low CO); >80% = distributive/poor utilization
Advanced Hemodynamics Overview
$149 CAD add-on — full ICU simulation curriculum
Hemodynamics Fundamentals
Included with RN/NP — preload, afterload, MAP
Shock & Perfusion
Apply PAC data to shock management
Cardiac Output Monitoring
Thermodilution, Fick principle, non-invasive methods
