Guide
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PULSION PiCCO plus CONTINUOUS CARDIAC OUTPUT PRELOAD VOLUME CONTRACTILITY EXTRAVASCULAR LUNGWATER CONTINUOUS DISPLAY OF VOLUME RESPONSIVENES
PiCCOplus setup AUX- Adapter cable PC81200
Central venous catheter Injectate temperature sensor housing PV4046 (included in PV8115)
AP
13.03 16.28 TB37.0
AP
140
117
92
(CVP) 5 SVRI
2762
PC CI
PCCI
3.24
HR
78
SVI
42
SVV 5% dPmx 1140 (GEDI) 625
Injectate temperature sensor cable PC80109
Interface cable for pressure signal PMK-206
Temperature interface cable PC80150 PULSION disposable pressure transducer ( e.g. PV8115) Arterial thermodilution catheter (e.g. PV2015L20)
PMK – XXX Connection cable to bedside monitor
PiCCOplus design – Rear panel PC81200 – Adapter cable for connection of PiCCO plus to bedside vital sign monitor
ON / OFF
serial Interface connection
Mains power connection cable
Potential equalization cable
PMK – XXX Connection to bedside monitor
Application sites for thermodilution catheters
axillary artery
(brachial artery)
PV2014L08 4F
8 cm
radial artery
PV2014L50LGWA
femoral artery
PV2015L20
4F
50 cm
5F 20 cm
PV2014L08*
more than 10 kg body weight
PV2013L07* 3F
* for application in paediatric patients
7 cm
Example of a PULSIOCATH – PV2015L20
Content:
Guidewire
20G 2 Cannulas 18G
PiCCO PULSIOCATH Dilator Pressure lumen Thermodilution - connector
Patient data Switch on the PiCCOplus PULSION PiCCO plus V 5.2.2 non US Last patient calibration at: 09.12. 14:37 201000200 75.0 kg 175 cm
Patient Weight Height
No
( 1
(
New patient?
2
1
By modification of patient ID number, date or time, patient related data is deleted and the system is ready to monitor a new patient.
2
To continue monitoring of the patient, press function key
.
Input menu (I) INPUT Patient Weight Height Catheter type PV 2015L20 Injectate temp sensor Injectate temperature Inj Vol (min. 15ml) CVP Range PCCO Range AP Warning PCCO
201000200 * 75.0 kg 175 cm ACC : 342 PV 4046 < 24 °C 15 ml 10 mmHg 0.. 10 l/min 60.. 160 mmHg 0.2.. 8.6 l/min
Enter Height and Weight of the patient for calculation of the indexed parameters.
*Changing this number will delete all previous data !
Input menu (II)
INPUT Patient Weight Height Catheter type PV 2015L20 Injectate temp sensor Injectate temperature Inj Vol (min. 15ml) CVP Range PCCO Range AP Warning PCCO
201000200 75.0 kg 175 cm ACC : 342 PV 4046 < 24 °C 15 ml 10 mmHg 0.. 10 l/min 60.. 160 mmHg 0.2.. 8.6 l/min
Arterial Catheter Constant (ACC) and the Injectate temperature Sensor Housing will be detected automatically, if the PULSIOCATH is connected < 24°C = room temp. injectate < 8 °C = cold injectate
Input menu (III) INPUT Patient Weight Height Catheter type PV 2015L20 Injectate temp sensor Injectate temperature Inj Vol (min. 15ml) CVP Range PCCO Range AP Warning PCCO
201000200 75.0 kg 175 cm ACC : 342 PV 4046 < 24 °C 15 ml 10 mmHg 0.. 10 l/min 60.. 160 mmHg 0.2.. 8.6 l/min
PV4046 Weight of pat.
For cold injectate
For roomtemp. injectate
< 3 kg
2 ml
3ml
< 10 kg
2 ml
3ml
< 25 kg
3 ml
5ml
< 50 kg
5 ml
10 ml
< 100 kg
10 ml
15 ml
≥ 100 kg
15 ml
20 ml
The mimimal injecate volume is recommended by the PiCCOplus in ( ), Parameter to be modified can be chosen by moving the inverse marker with The highlighted parameter can be changed using the function keys
.
Input menu (IV) INPUT Patient Weight Height Catheter type PV 2015L20 Injectate temp sensor Injectate temperature Inj Vol (min. 15ml) CVP Range PCCO Range AP Warning PCCO
Upper / lower limit for the display scaling for the cardiac output trend display
201000200 75.0 kg 175 cm ACC : 342 PV 4046 < 24 °C 15 ml 10 mmHg 0.. 10 l /min 60.. 160 mmHg 0.2.. 8.6 l /min
CVP should be updated when the CVP changes ± 5 to accurately calculate SVR
Upper / lower warning limits for pulse contour cardiac output
Pressure zeroing menu AP ZEROING
apply
Zero adjust
0 mmHg 15 mmHg
(
measured AP
1
Open pressue transducer to atmosphere.
( ( 2
Press
for zeroing
3
... next screen
Perform zero adjustment first on PiCCOplus then on bedside monitor!
AP correction menu Recalibration (thermodilution) is necessary after each change of AP-correction!!! If necessary, enter the difference between pressure transducer and the heart by pressing AP CORRECTION
AP Correction
0 cm
(
…change to main menu
Main display 1 Thermodilution display page 2 Configuration menu PULSION PiCCO plus V 5.2.2
3 Input menu
non US
4 Pulse contour display page 5 Pressure zeroing menu
1
2
3
4
5
Configuration menu – Parameter selection CONFIGURATION
Configure Display
Date 09.12.02* Time 15:33 * (change deletes previous results) Parameter selection
individual
Display span
5d
Language Loudness
ENG 4
(CVP) PVPI SVR SV SVV PPV/dPmx GEF/CFI TB PPV/dPmx GEF/CFI ITBV/GEDV
(individual) on on on on on on on on dPmx CFI GEDV
Individual parameter configuration: Basic setup: Most common parameters are displayed as default Individual selection: Customer can configure own parameter selection (except of most important PiCCO parameters) *By modifiation of date or time, patient related data is deleted and the system is ready to monitor a new patient.
Thermodilution display page (I) 201000200 TIME ST MEAN
2
0 READY
117 71
09.12. 15:33 TB37.0 CI
CFI
GEDI
*.**
**.*
****
10s
20s
AP ELWI 97 **** (CVP) 12 SVRI ****** PC **.**** CI 78 HR SVI ***
TI 20
SVV dPmx (GEDI)
% 81530 ****
( 1
to perform a thermodilution 1 Press measurement. 2 Wait until “STABLE“ appears 3 Injection of the indicator should be done as fast (< 7 sec) and steadily as possible.
117 71 **** (CVP) 12
09.12. 15:33 TB37.0 201000200 AP TIME ST CI CFI GEDI ELWI 97 MEAN
*.**
**.*
****
SVRI ****** PC **.**** CI HR 78 SVI ***
3 00 10s 10s INJECTION
20s 20s
TI 20
SVV dPmx (GEDI)
% 81530 ****
Thermodilution display page (II) 201000200 ST
117 71
CI CFI GEDI ELWI AP 479 2.92 4.3 * 7 97 7 2.92 4.3 479
(CVP) 12 SVRI 2157 PC CI HR 78 SVI 38
2.38
0
10s 10s 10s
10s
2
20s
(
000
8%
SVV 20s PPV 12% 20s 20s T 0.24 / TI 12 (GEDI) 479
(
1
TIME 11:49 MEAN
09.12 15:33 TB37.0
1 Initially please perform 3 thermodilution measurements for further 2 Press thermodilution measurement 3 ...change to thermodilution info screen
3
*If EVLWI ≥ 10 ml/kg the use of cold injectate is recommended. Don`t forget to select for iced injcectate < 8°C in the Input menu.
Thermodilution info screen TD info screen provides enhanced information about the last 50 TD measurements
117 TIME ST CI GEF GEDI ELWI AP 97 71 8 2.81 26 450 0 07:02 09.12 15:33 TB37.0
201000200
07:03 07:05 11:56 11:58 11:59 15:05 15:06 15:29 MEAN 00
3.06 3.16 3.22 2.90 3.24 2.92 3.15 2.96 2.96 10s 10s
10s
8 24 474 12 (CVP) 8 26 489 SVRI 2157 8 26 496 PC 25 7 475 CI 26 509 8 HR 78 24 6 520 38 SVI 8 25 502 24 8 480 SVV 8 24 480 PPV 12% 20s 20s T 0.31/ TI 12 (GEDI) 479 20s
TIME 15:29
ST 0
CI 2.96
GEF 24
2.38 8%
GEDI 480
TB37.0 ELWI AP 97 8
117 71
(CVP)
12
SVRI PC CI
2157
HR SVI
78 38
2.38
0 00
0
10s 10s 10s 10s
8%
SVV 12% 20s 20s PPV 20s T 0.31 / TI 12 (GEDI) 479 20s
( (
0
0 0 0 0 0 0 0 0
09.12 15:33
201000200
1
2
1 The last 5 TD curves can be displayed graphically by pressing 2 To delete a TD measurement of the valid calibration, highlight the measurement you want to delete and press two times.
Most important data from the thermodilution values from the thermodilution 201000200
CI = Cardiac index
CFI = Cardiac Function Index or GEF = Global Ejection Fraction
TIME 11:59 15:05 15:06 15:29 MW
0
00 0
ST CI 0 3.24 0 2.92 0 3.15 0 2.96 2.96
continuous values
09.12 15:33 TB37.0
CFI 5.0 5.0 5.0 5.0 5.0
10s
10s 10s
10s
GEDI = Global end diastolic volume index or ITBI = Intrathoracic blood volume index
117 71
AP GEDI ELWI 97 450 8 8 (CVP) 12 489 8 SVRI 2157 520 8 PC 480 8 CI 480 78 HR SVI 38
2.38 8%
SVV 20s dPmx 1530 20s T 0.31 / TI 12 (GEDI) 479 20s
Continuous Cardiac Output (PCCO) (mean value of the last 12 seconds)
Stroke Volume Variation (SVV)
20s
ELWI = Extravascular lung water index
Pulse contour display page 09.12 15:33 TB37.0
201000200 AP
160
117 71
AP 97
(CVP) 12 SVRI 2157 PC CI 20 HR 78 20 SVI 38
2.38
1h
6
0
10s
20s
8%
SVV PPV 12% 0 (GEDI) 479
(
PCCI
... change to info screen
Trend of continuous cardiac output (PCCO), Time scale was defined in the Configuration menu (1h – max. 5 days)
Info screen 09.12 15:33 TB37.0 AP 160 97
201000200 AP
117 71
(CVP) 12 SVRI 2157 PC CI 78 HR 20 20 SVI 38 6 SVV PPV 12% (GEDI) 479 0
2.38
( (
10s
20s
2
(ZVD) 12 SVRI 2157 PC HI 78 CR 0 38 SVI
Last PCCO calibration
0
0
10s 10s
10s
20s20s
20s
1
1
Press
2
... change to the patient profile screen
117 71
2.38
8%
PCCI
1h 0
201000200 09.12 15:33 TB37.0 AP 97 160 AP
to get information about the last PCCO calibration
8%
SVV 12% PPV (GEDI) 479