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13 Monitoring Cardiac Output C.O. Injectate Guidelines
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C.O. Injectate Guidelines
The greater the injectate volume and the colder the temperature, the more accurate the measurement.
Reduced injectate volume or higher injectate temperature may reduce the specified accuracy.
For adult patients, to ensure the greatest measurement accuracy, use a cold injectate (< 8
°C) of 10 ml
volume, if not contra-indicated by the patient's condition. Your choice of injectate volume should be
based on the injectate temperature and the patient’s cardiac output.
Guidelines for Right Heart Thermodilution C.O. Injectate
If you are using the right heart thermodilution method, the use of injectate with a temperature less
than 8
°C lower than the blood temperature may cause incorrect values for the thermodilution.
Guidelines for PiCCO C.O. Injectate
If you are using the PiCCO method, the use of injectate with a temperature less than 12°C lower than
the blood temperature may cause incorrect values for the thermodilution and CCO calibration.
Injectate Volume, Patient Weight and ETVI Values (PiCCO Only)
When deciding on an injectate volume and temperature, you must consider your patient’s weight and
extra-vascular thermal volume index (ETVI).
High ETVI: The dilution of injectate is influenced by extravascular tissue and fluid. The accuracy of
the PiCCO method may be reduced in patients with high extra-vascular thermal volume index (ETVI)
values. Use the table below as a guide in selecting the correct injectate temperature. As shown in the
table, if your patient has an ETVI > 10, you must use cold injectate.
Weight: Use the table below as a guide in choosing an injectate volume appropriate for the patient
weight.
Patient Weight Cold Injectate Room Temperature Injectate
ETVI < 10 ETVI ≥ 10 ETVI < 10 ETVI ≥ 10
< 3 kg 2 ml 2 ml 3 ml Use cold injectate
< 10 kg 2 ml 3 ml 3 ml
< 25 kg 3 ml 5 ml 5 ml
< 50 kg 5 ml 10 ml 10 ml
< 100 kg 10 ml 15 ml 15 ml
≥ 100 kg 15 ml 20 ml 20 ml