Automatic Shunt Calculations (QP/QS Ratio) Calculation

Automatic Shunt Calculations - (QP/QS Ratio) Calculation Interventional Radiography: Cardiac If a Shunt calculation is performed, all shunt results including PBF/ SBF Ratio are saved and printed in the Sensis Report. Both Hemodynamic Report (2) and Hemodynamic Report (3) include the (PBF/SBF Ratio) = (QP/QS Ratio). Shunt Calculations are automatically performed, Sensis requires that you take 02 Sats from the following sites. MV Before the right heart - mixed venous PA After the right heart - pulmonary ar- PV Before the left heart - pulmonary Note: Sensis assumes PV = 96% if not SART After the left heart - Systemic artery Assume the following 02 Saturation results are entered indicating a LEFT to RIGHT shunt. (Figure 1) RA = 60% PA = 78% RPA = 81% AO = 96% Enter 02 Sat Results Sample Site AO Q2 Sat Sample Site PARPY AO Time RA PA Click "Close" It is not necessary to 02 Set (%) 36 click the "Adjust Shunt" button, Sen- sis will automatically detect a shunt 202 (mmHg) if present. Include Average for AO Note: The "Adjust Shunt" button is 02 Sat 96:00 used to return to the Shunt Fick PO2 mmHg Adust Shunt window where different 02 Sat re- sults can be exchanged. Close Figure 1 SIEMENS siemens.com/healthineers Healthineers Job Aid | Automatic Shunt Calculations - (QP/QS Ratio) Calculation Effective Date: 09/08/2016 | Quality HOOD05162002747040 The following Shunt results are displayed. Note: The RPA Sat is used in the shunt calculation. Shunt Fick x Shunt Fick Event Properties x Heart Rate General | Specific QP/QS=PBF/SB bpm Heart Rate 60 bpm Systemic Blood Flow 5.15 Vmin F Ratio=2.35 Hemoglobin Pulmonary Blood Flow 12.12 Vmin HB 10:00 9/100m Enter Systemic Stroke Volume 85.91 ml/beat Pulmonary Stroke Volume 201.99 mi/beat 02 Consumption L-R Shunt Flow 6.96 ymin 1. Click the "Calculate Predicted @ 260.57 mi/min R-L Shunt Flow Flows" button. Measured mimin Erser Pulm/Sys Flow Ratio 2.35 Left to Right Ratio 0.57 02 Saturations Right to Left Ratio Mixed Venous RA 60.00% 02 Consumption 260.57 ml/min HB 10.00 g/100ml Pulmonary Artery PARP 81,00% 2. Click the "OK" button Systemic AV 02 diff 50.55 Pulmonary Vein AO 96.00% Pulmonary AV O2 diff located in the bottom of 21.50 min Systemnic Artery Shunt Properties win- AO 96.00% Site 02 Spr 02 (% (ml/) dow in order for the re- Shunt Ratios Mixed Venous RA 60.00 82.51 sults to appear on re- Right to Left Ratio Pulmonary Artery PARP 81.00 111.56 port. Left to Right Ratio 057 Pulmonary Vein AO 96.00 133.06 Pum/Sys Flow Rato 2.35 Systemic Artery AC 96.00 133.06 Calculate Flows Close OK Cancel Figure 2 Calculated Shunt results can be reviewed during examination using the Hemodynamic Worksheet Icon. Located on the right side of the DMC display. (Figure 3) Figure 3 Siemens Healthineers Services Page 2 of 4 Job Aid | Automatic Shunt Calculations - (QP/QS Ratio) Calculation Effective Date: 09/08/2016 | Quality HOOD05162002747040 The shunt can be adjusted by selecting a different 02 Sat result. Example: Replacing the RPA Sat result with the PA Sat result. (Figure 4) Shunt Fick X Shunt Fick Event Properties X Heart Rate General | Specific BR 60 bom Heart Rate 60 bom Systemic Blood Flow 5.15 Vmin Hemoglobin Pulmonary Blood Flow 10.15 Umin Re- calculated HB 10.00 9/100ml Enter Systemic Stroke Volume 85 91 mibeat Pulmonary Stroke Volume 169.11 mibeat QP/QS Ratio)= (PBF/SBF Ratio) = 1.97 02 Consumption L-R Shunt Flow 4.99 V/min Predicted @ 260.57 mi/min R-L Shunt Flow using PA Sat. Measurey ‹ mi/min Enter Pulrn/Sys Flow Ratio 1.97 Left to Right Ratio 0.49 02 Saturations Right to Left Ratio Mixed Venous RA 60.00% 02 Consumption 260.57 mi/min HB 10:00 2/100ml Use the Pulmonary Artery PA 78.00% Systemic AV 02 diff 50 55 'Calculate Pulmonary Vein AO 96.00% Pulmonary AV 02 diff 25.68 Flows" button, Systemic Artery AO 96.00% Site 02 SE 02 and the "OK" (%) Shunt Ratios Minted Venous RA 60.00 -82:51 button to re- cal- Right to Left Ratio Pulmonary Artery PA 75:00 107.38 culate the shunt Left to Right Ratio 0.49 Pulmonary Vein AO 96 00 133.06 1.97 Systemic Artery 96.00 Pum/Sys Flow Ratio AO 133.06 with the PA 02 Calculate Flows Close OK Cancel Figure 4 Note #1: If a shunt is not determined then no (PBF/SBF Ratio) appears in the Sensis report. Note #2: The Hemo WS Report does NOT contain the PBF/SBF Ratio Index. Siemens Healthineers Services Page 3 of 4 Job Aid | Automatic Shunt Calculations - (QP/QS Ratio) Calculation Effective Date: 09/08/2016 | Quality HOOD05162002747040 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively "Operator Manual") issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. 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