N.

Hemodynamic Monitoring
Hemodynamic monitoring measures the blood pressure inside the veins, heart, and arteries. It also
measures blood flow and how much oxygen is in the blood. It is a way to see how well the heart
is working.
Purpose of monitoring:
- Early detection, identification and treatment of life threatening conditions such as heart
failure and cardiac tamponade
- Evaluate response to treatment such as drugs and mechanical support
- Evaluate effectiveness of cardiovascular functions such as cardiac output and index
1. Cardiac Enzymes
- It measure the levels of enzymes and proteins that are linked with injury of the heart
muscle. These include the enzymes creatine phosphokinase (CPK) and creatine kinase
(CK), and the proteins troponin I (TnI) and troponin T (TnT). Low levels of these enzymes
and proteins are normally found in your blood, but if your heart muscle is injured, such as
from a heart, the enzymes and proteins leak out of damaged heart muscle cells, and their
levels in the bloodstream rise.

2. Blood Pressure, Mean Arterial Pressure(MAP) and Cardiac Rate

- MAP detects whether there is enough blood flow, resistance and pressure to supply blood
to all major organs of the body. A high MAP or blood pressure can eventually lead to blood
clots or damage to the heart muscle, which has to work a lot harder. Many things that cause
very high blood pressure can also cause a high MAP, including: heart attack, kidney failure
and heart failure. A decreasing cardiac output could be a complication of heart failure that
is brought about by coronary artery disease.

- Normal values: BP = 90/60 to 120/80; MAP= 70 to 100 mmHg; CR= 60-100 bpm

3. SpO2
- It stands for peripheral capillary oxygen saturation, an estimate of the amount of oxygen in
the blood. More specifically, it is the percentage of oxygenated hemoglobin (hemoglobin
containing oxygen) compared to the total amount of hamoglobin in the blood (oxygenated
and non-oxygenated hemoglobin). This should be measured to know if there is effective
cardiac pumping and good tissue perfusion.
- Normal Value = 95% -100 %
4. Hemoglobin and Hematocrit
- A low hemoglobin level in the blood, is often linked to heart disease because the heart has
to work harder to pump more blood and oxygen through the body. Low levels of these
blood component results from a heart failure as a complication of coronary artery disease.
5. Central Venous Pressure
- It reveals intravascular volume status and right ventricular function. This may be an
indicator if there is heart failure in the patient.
- Normal values = 2 – 8 mm Hg
 Low CVP = hypovolemia or ↓ venous return
 High CVP = over hydration, ↑ venous return, or right-sided heart
failure

6. Creatinine and BUN

- High levels of these may accumulate to the circulation as a result of decreased and renal
perfusion brought about by heart failure.

7. Lipid Profile
- A high blood levels of low-density lipoprotein (LDL) cholesterol, and fats called
triglycerides, or both increase risk for developing heart disease.
- Normal Values: Total Cholesterol = <200; LDL = <130; HDL= >60; Triglycerides= <150
8. CBG
- A high blood glucose can damage your blood vessels and the nerves that control the heart
and blood vessels.
- Normal Values= 70-110 mg/dl