ICU Vivas · Resuscitation
The arterial line — pressure transduction
A CICM equipment viva on the arterial line — the physics of fluid-filled pressure transduction, zeroing and levelling, the waveform and its artefacts (damping and resonance), and the safe insertion and complications. A classic cross-table viva topic.
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CICMFFICMEDIC
Prompt
Explain how an arterial line measures pressure, and how you would troubleshoot an under-damped trace.
Stimulus
The examiner places an arterial line transducer set in front of you (or shows a pressure trace) and asks: how does this actually measure a blood pressure, and what would you do if the trace looked like this? In septic shock, an accurate, beat-to-beat arterial pressure is essential — it guides vasopressor titration to a MAP of at least 65 mmHg and allows frequent arterial blood sampling.[1]
References3ShowHide
- [1]Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive Care Medicine, 2021.PMID 34599691
- [2]Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016.PMID 26903338
- [3]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.