PULSION PiCCO2 - Operational Flow Chart

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Appendix

Page E-18 Operator’s Manual PiCCO

Version 3.1

6 Flow chart

Main Page

Table of Contents3
List of Figures7
A General Information10
Indications10
Contraindications10
Warnings11
Safety Instructions13
B Principles of Measurement and Parameters15
Introduction15
Transpulmonary Thermodilution Technique16
Principle16
Transpulmonary Cardiac Output16
Figure 1: Heart-Lung Circulation and Resulting Thermodilution Curve16
Transpulmonary Volume Determination17
Gedv / Itbv17
Evlw17
Figure 2: GEDV / ITBV17
Additional Thermodilution Parameters18
Figure 3: Extravascular Lung Water (EVLW)18
Figure 4: Global Ejection Fraction (GEF)18
Continuous Pulse Contour Analysis19
Principle19
Calibration of the Pulse Contour Cardiac Output19
Figure 5: Calibration of Pulse Contour Analysis by Means of Thermodilution19
Continuous Haemodynamic Determination20
Map / Cvp / Hr20
Pcco20
Svv / Ppv20
Svr20
Cpo21
Dpmx21
Figure 8: Dpmx21
Central Venous Oximetry22
Principle22
Determination of Scvo22
Oxygen Delivery and Oxygen Consumption: DO22
Figure 9: the Principle of Spectrophotometry22
Pulse Oximetry and Pulse Dye Densitometry23
Principle of Pulse Oximetry23
Principle of Pulse Dye Densitometry23
Figure 10: Absorption Spectra of O Hb, Hb and ICG (According to Britton Chance, University of Pennsylvania)23
Principle of ICG Elimination Detection24
Parameters of Pulse Oximetry and Pulse Dye Densitometry24
Figure 11: Schematic Representation of the ICG Elimination Curve24
Parameter Groups and Ranges of Normal Values25
Figure 6: SVV25
Figure 7: PPV25
C Installation and Setup27
Unpacking and Inspection27
Functionality and User Interaction29
Screen Elements29
User Interaction29
Figure 12: Screen Elements29
Touchscreen30
Function Keys30
Figure 13: Function Keys30
Navigation Dial and Navigation Keys31
Setup and Measurement: Step by Step32
Connectors and Connections32
Patient Cables32
Figure 14: Patient Cables Socket with Equipment Class (Defibrillator Protection)32
Monitor Connections33
Figure 15: Monitor Connections33
Patient and Monitor Wiring34
Figure 16: Patient and Monitor Wiring34
Thermodilution and Pulse Contour Analysis35
Central Venous Oxygen Saturation36
Application of Injectate Temperature Sensor Housing and Cevox Probe at the same Time36
Transmission of Continuous Pressure to Bedside Monitor36
Setup and Start37
Mains Voltage37
Switch on the Device37
Enter Patient Data38
Figure 17: Start Screen38
Figure 18: Catheter Position39
Figure 19: Input Screen40
Zero Adjustment41
Zero Adjustment of Arterial Pressure (AP) and Central Venous Pressure (CVP41
Figure 20: "Zero Adjustment" Screen41
Central Venous Oxygen Saturation42
Scvo Calibration42
Figure 21: "Scvo Calibration" Screen: Blood Sample Withdrawal43
Figure 22: "Scvo Calibration" Screen: Input of Lab Values43
Sao Input44
Indocyanine Green (ICG) Measurement45
Non-Invasive ICG Measurement45
Display of Results47
Figure 23: Scvo Input Screen47
Figure 24: PDR Curve and Results47
Calculation of ICG Quantity48
Figure 25: ICG Calculator Screen48
Thermodilution and Calibration of Pulse Contour Analysis49
Figure 26: "Thermodilution" Screen49
Figure 27: Selection of "Inj. Volume" Option with Help Screen "Recommended Inj. Volume49
Figure 28: Recommended Injectate Volume Depending on Body Weight51
Figure 29: Thermodilution Curve52
Display Options53
Information Bar53
Real Time Pressure Curve54
Figure 30: Real Time Curve of Arterial Pressure54
Parameter Fields55
Figure 31: Parameter Fields55
Profiles56
Figure 32: "Profiles" Screen56
Spidervision57
Figure 33: "Spider" Screen57
Trend58
Figure 34: "Trend" Screen58
Monitor and Display Configuration59
Patient Settings59
Information Input59
Figure 35: "Patient Settings" Screen59
Predicted Body Weight60
Monitor Settings60
Figure 36: "Monitor Settings" Screen60
Configuration of Parameter Display61
Figure 37: "Parameter Configuration" Screen61
Setting of Alarm Limits62
PCCI Change Warning62
Parameter Settings63
Spider Configuration64
Figure 38: "Spider Configuration" Screen64
Trend Configuration65
Figure 39: "Trend Configuration" Screen65
Measurement Configuration66
Configuration of Thermodilution Measurement66
Figure 40: "Measurement Configuration" Screen66
Configuration of Central Venous Catheter67
Configuration of Scvo Measurement67
Configuration of ICG Measurement67
Normal and Target Values68
Figure 41: Normal- / Target Value Range68
Alarms, Messages and Troubleshooting69
Alarms70
Error Messages70
Additional Information73
Help Functions75
Printout76
USB Virtual Printing Option76
Label Printer76
Battery Function77
Cleaning and Disinfection78
General Remarks78
Precautions78
Cleaning79
Disinfection79
D Disposables / Accessories81
Disposables81
Picco Catheter (Arterial Thermodilution Catheter81
Picco Monitoring Kits82
Injectate Temperature Sensor Housing82
Cevox Probe83
Accessories84
E Appendix85
Technical Data85
Maintenance and Service88
Classification88
Maintenance88
Disposal of Electrical and Electronic Equipment89
Interfaces90
EMC-Requirements91
Equations for Calculated Values95
General95
Output96
Preload Volume97
Afterload98
Contractility99
Organ Function99
Oxygenation100
Flow Chart102
Symbols103
Warranty104

PULSION PiCCO2 - Operational Flow Chart

Table of Contents