Swan Placement on CXR
- Ideal tip: Proximal R/L pulmonary artery, ~3–5 cm beyond carina, near hilum.
- Path: SVC → RA → RV → PA → branch.
- Goal: In West zone 3 for accurate wedge pressures.
- Too proximal: In RV → arrhythmia risk.
- Too distal: In segmental PA → rupture risk.
- Tip should project over hilum, not past lateral chest wall, ≤2 cm beyond hilum.
Swan Interpretation
- Right heart failure: high CVP, low CI, high PVR
- Left heart failure: high PCWP, low CI, high SVR
- Pericardial tamponade: high PCWP, high SVR, CVP = PCWP
- Hypovolemia: low CVP, low PCWP, low CI, high SVR
- Cardiogenic: high CVP, high PCWP, low CI, high SVR
- Sepsis (Distributive): low CVP, low PCWP, high CI, low SVR
Swan-Ganz Calculator
| INPUTS | Invasive Hemodynamics (24 hours) | OUTPUT | Normal Values |
|---|---|---|---|
| BSA | Cardiac Output (CO) | -- | 4-6 L/min |
| PaO2 | Cardiac Index (CI) | -- | 2-4 L/min/m² |
| ScVO2 | SvO2 (%) | -- | 65-75% |
| Hgb | SaO2 (%) | -- | 94-100% |
| MAP | SVR | -- | 900-1400 dynes*sec/cm^5 |
| CVP | PVR | -- | <2.8 Woods Units |
| PAWP | RA (Mean) | -- | 1-6 mmHg |
| PAPs | PA (S/D/Mean) | -- | 25/10/15 mmHg |
| PAPd | PCWP (Mean) | -- | 6-11 mmHg |
| PAPm | AO (S/D/Mean) | -- | Mean >60 mmHg |
| ABPs | CPO | -- | If <0.6, LV Failure |
| ABPd | PAPI | -- | If <0.9, RV Failure |
| ABPm |