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Documenting C.O. Measurements 13 Monitoring Cardiac Output
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If you are using the ice-bath setup, the injectate temperature probe and the injectate are both placed in
an ice-bath and the probe measures the temperature of the contents of the ice bucket.
Setting the Computation Constant
Check that the correct Computation Constant is entered in the C.O. procedure window. This can
be found in the documentation supplied with the catheter and is based on the injectate volume,
injectate temperature and catheter type. To change the value, in the C.O. procedure window, select
Computation Constant and use the pop-up keypad to enter the correct value.
Performing RH C.O. Measurements
1 Enter the C.O. procedure window.
2 When you see the message ...Ready for new measurement, select the pop-up key Start
C.O.
3 When you hear a ready tone and see the message ...Inject now!, inject the solution into the
right atrial port of the Swan-Ganz catheter. The optimal injection rate is 2.5 ml/second.
At the end of the measurement the thermodilution curve, cardiac output, index values and curve
alerts (if necessary) 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 six
measurements before editing. If you perform more than six measurements without rejecting any,
the oldest will automatically be deleted when a seventh curve is stored.
Editing and Saving RH C.O. Measurements
It is important to identify and reject erroneous measurements (called “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
you can accept or reject trials directly by tipping on the trial curve. Discard conspicuously different
values. The background of rejected trials is red and the background of accepted trials is green. The
monitor recalculates the average values after you reject or accept trials.
If all values are different from each other, there may be true hemodynamic instability caused, for
example, by severe cardiac arrhythmia.
3 Save average C.O. values. To close a measurement series, you must save the average values by
selecting the pop-up key
Save C.O. This sends the average C.O. numeric to be displayed on the
main screen, and stores the averaged values in the trends and calculations databases.
Documenting C.O. Measurements
You can document C.O. measurements on the default printer or recorder.
1 In the C.O. procedure window, select the pop-up key Print/Record.