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13 Monitoring Cardiac Output Accessing the Setup C.O. and Setup CCO Menus
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Accessing the Setup C.O. and Setup CCO Menus
C.O. settings can be changed in the Setup C.O. menu. To access this menu,
♦ press the C.O. hard key on the C.O. module
♦ select any of the discontinuous C.O. numerics (for example, C.O., C.I.) on the screen.
CCO/CCI settings can be changed in the
Setup CCO menu. To access this menu,
♦ select any of the continuously measured hemodynamic numerics (CCO, CCI.) on the screen.
Entering the HemoCalc Window
♦ From the C.O. procedure window, select the pop-up key HemoCalc to open the HemoCalc
window.
Measuring C. O. Using the PiCCO Method
The PiCCO method combines transpulmonary thermodilution and pulse contour analysis on the
blood pressure waveform. A fluid with a known volume and temperature is injected into the right
atrium through a CVP catheter. The injectate bolus mixes with the blood in the heart and the change
in blood temperature is measured with a thermistor at the distal end of an arterial catheter placed in
one of the bigger systemic arteries, for example, the femoral or the axillary artery.
The PiCCO Method requires a pressure measurement made using either the M1006B Pressure
module, or a M3001A MMS, or a measurement server extension M3015A, M3014A, or M3012A. (A
VueLink pressure may not be used.) You will also need a conventional central venous (CVP) line and
an arterial catheter from Pulsion Medical Systems. You must use the approved catheters and puncture
locations.
Measuring Continuous Cardiac Output
Every time C.O. is measured with the PiCCO method, the monitor uses this C.O. value and the result
of the pulse contour analysis to calculate a patient-specific calibration factor. The monitor uses this
value to compute CCO and the other continuous hemodynamic parameters. CCO values are
calculated on a beat-to-beat basis and then averaged over a 12-second time frame. The calculated values
are displayed as numerics on the monitor screen.
Measuring Systemic Vascular Resistance
The monitor uses CCO, an arterial pressure, and CVP to calculate a continuous SVR value. If a
continuously measured CVP value is not available, the monitor uses a preset, static CVP value to
calculate the SVR (you will see the INOP message
SVR SET CVP USED). If the BSA is available, the
monitor uses the CCI to calculate the SVRI.
SVR/SVRI settings can be changed in the Setup SVR/SVRI menu. To enter the menu, select ->
Main Setup -> Measurements -> SVR or SVRI.
To display a SVR/SVRI numeric on the Screen, select any numeric, then select Change Numeric
and select SVR or SVRI from the list of available numerics.