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13 Monitoring Cardiac Output Measuring C. O. Using the PiCCO Method
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Check that the correct arterial catheter constant is selected.
If the catheter is recognized by the monitor, the catheter constant is automatically displayed and
cannot be changed manually. If it is not recognized, in the C.O. procedure window, select
CathCt
and use the pop-up keypad to enter the correct value. The catheter constant is usually written
either on the catheter or on the catheter packaging.
9 Make sure that the injectate volume setting matches the injectate volume you will use. To change
the volume, in the C.O. procedure window, select
InjVol and select the correct injectate volume
from the pop-up list.
If there is a problem with the volume or temperature you have chosen, the monitor will issue a curve
alert message to inform you of this.
10 If you are measuring CCO or CCI, check that the correct pressure source is selected in the
Setup CCO menu. The pressure label under CCO from must match the pressure measured with
the arterial catheter. To change the pressure source, select
CCO from to call up a list of available
pressure labels and select the correct label.
11 If you are measuring CCO or CCI, verify that the correct alarm source is selected in the menu item
Alarms From. To change the alarm source, select Alarms From and choose either CCO or CCI.
Performing PiCCO C.O. Measurements
Always wait for the monitor to indicate readiness for the next step before proceeding.
If you are measuring CCO, all measurements should be conducted within 15 minutes. Older
measurements “expire” for CCO calibration.
1 Enter the C.O. procedure window.
2 When you see the message ...Ready for new measurement, start the measurement by
selecting the pop-up key
Start C.O. or pressing the Start hardkey on the C.O. module, or
pressing the remote start switch.
3 When you hear the ready tone and see the message ...Stable baseline, inject now!,
inject the solution into the CVP catheter.
At the end of the measurement the thermodilution curve, cardiac output, index values, ITBV and
EVLW values and any curve alerts are displayed and a message will appear “
...Wait before
starting new measurement
”.
4 When you see the ...Ready for new measurement message, repeat the procedure until you
have completed the measurements you want to perform. You can perform a maximum of 6
measurements before editing. If you perform more than 6 measurements without rejecting any, the
oldest will automatically be deleted when a 7th curve is stored.
Editing PiCCO C.O. Measurements
It is important to identify and reject erroneous trials, as the monitor uses all the measurement trial
values you do not reject to calculate the averaged cardiac output.
1 Review the trials. Irregular trials or trials marked with a “?” should be reviewed carefully. Consider
the similarity of the values and the shape of the C.O. curve. A normal C.O. curve has one smooth
peak and returns to the temperature baseline level after the peak.
2 Reject unsatisfactory trials: use the Select Trial pop-up key to move between trials, then
select the Accept Reject pop-up key to accept or reject trials. If you are using a touch screen