12 Monitoring Cardiac Output
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Documenting C.O. Measurements
You can document C.O. measurements on the default printer or recorder.
1 In the procedure window, select the pop-up key Print/ Record.
2 From the pop-up list, choose:
–
Print Results to print the contents of the procedure window
–
Record Results to record the contents of the procedure window
–
Record Trial to send an individual trial curve to the recorder.
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 that is not at least 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.