12 Monitoring Cardiac Output
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If you are measuring CCO, set up the pressure measurement now. The CCO measurement requires
a minimally dampened invasive pressure setup. You must ensure that there are no air bubbles in
the pressure line or dome and use only specified accessories.
6 Check that the correct measurement method is selected.
If a catheter is already connected to the Cardiac Output Interface Cable, the monitor automatically
recognizes the method used. If not, in the
Setup C.O. menu, select Method and then select
Transpulmnry.
7 Check that you are using the correct probe - the M1646. This is the only probe supported for use;
it can be used with room temperature injectate or with cold injectate.
8 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 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 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 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. If the measuring mode is set to
Auto the Start C.O. key will also enable the automatic
start of consecutive measurements.
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
or in Auto mode Prepare for next injection or press Stop.
4 When you see the Stable baseline, inject now! 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.
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