26-12 DELTA/DELTA XL/KAPPA VF8
26 P
ULSE CONTOUR CARDIAC OUTPUT (PICCO) MONITORING
16. Inject the bolus solution into the patient’s bloodstream only after you see the
READY message. A thermodilution curve appears, displaying the change in
blood temperature and a p-CO value is computed.
17. Repeat step 15 to take an additional measurement, making sure you wait for
the READY message. If a temperature drop is not detected within four
minutes, the Averaging screen closes, and the current p-CO values will be
averaged and saved. You must repeat steps 15 and 16 if additional p-CO
measurements are necessary.
Averaging p-CO Measurements
Differences in injection technique can cause variations in measurements performed on
the same patient. To compensate for such discrepancies, you can review results of up to
five measurements and use them to compute a p-CO average. The p-CO Averaging
screen is displayed whenever you begin a p-CO measurement. The Review Curves
screen duplicates the five values displayed on the p-CO Averaging screen with their
corresponding thermodilution curves.
NOTE: If the READY message fails to appear or appears only intermittently, the blood
temperature may be unstable. Check that all connections are correct and that the blood
temperature is stable and valid and repeat step 15 (see page 26-23 for suggestions to
optimize PiCCO measurements).
NOTE:
During measurements, the patient's condition needs to be stable and
administration of infusions and injections should be discontinued. The blood
temperature (p-BT) should not be lower than 30 °C.
Iced (< 8°C) or room-temperature injectate < 24 °C can be used. The maximum
temperature decrease (T) at the measurement point should be > 0.15 °C.
To achieve a usable thermodilution signal, Pulsion recommends that the volume
of injectate to be used should be based on the following table:
EVLWI < 10 EVLWI > 10 EVLWI < 10
kg body weight iced iced room temperature
< 3 2 ml 2 ml 3 ml
< 10 2 ml 3 ml 3 ml
< 25 3 ml 5 ml 5 ml
< 50 5 ml 10 ml 10 ml
< 100 10 ml 15 ml 15 ml
> or = 100 15 ml 20 ml 20 ml